CTCA image
A CTCA image of the LAD has been added to the Other diagnostic modalities in ACS page.
Cardiology
Pre PCI beta blockers
The Management of acute coronary syndromes page has been updated with additional information about the role of pre-PCI beta blockers. Roolvink, V, Ibanez, B, Ottervanger, JP, et al. Early Administration of intravenous Beta blockers in patients with ST-elevation myocardial infarction before primary PCI. Journal of the American College of Cardiology 2016.
Myoglobin in ACS
The Other cardiac biomarkers page has been updated with additional information about the role of myoglobin in excluding ACS in low risk patients. Meek, R, Braitberg, G, Cullen, L, et al. Outcome at 30 days for low-risk chest pain patients assessed using an accelerated diagnostic pathway in the emergency department. Emerg Med Australas 2016.
Risk stratification for ACS in patients < 40 years of age
The Risk stratification in suspected ACS page has been updated with additional information about the characterstics of patients with ACS who are < 40 years of age.
Inferior MI ECG changes
The ECG in acute coronary syndromes page has been updated with additional information about determining which artery is likely the source of the culprit lesion in inferior MI.
ECG of hyperventilation T wave changes
The ECG in acute coronary syndromes page has been updated with an ECG demonstrating T inversion secondary to hyperventilation.
Causes of T wave inversion
The ECG in acute coronary syndromes page has been updated with a short segment on non ACS causes of T wave inversion.
ST elevation in gastric volvulus
The ECG in acute coronary syndromes page has been updated with gastric volvulus added to the possible caused of ST elevation.
Oesophageal reflux management
The Oesophageal causes of chest pain page has been updated with additional management to prevent symptoms.
Diagonal branch of LAD occlusion
A short segment outlining the ECG features of a first diagonal branch LAD occlusion has been added to the ECG in acute coronary syndromes page.
CTCA
The segment on CTCA on the Other diagnostic modalities in ACS page has been revised and updated.
Epipericardial fat necrosis
A small segment on epipericardial fat necrosis has been added to the Pericarditis page.
Subsegmental PE
Additional information about the management of isolated subsegmental PE has been added to the Management of PE page. Kearon, C, Akl, EA, Ornelas, J, et al. Antithrombotic therapy for vte disease: Chest guideline. Chest 2016 .
Takostubo cardiomyopathy
Some additions have been made to the segment on Takotsubo cardiomyopathy in the MINOCA page.
T inversion in aVL
The ECG in coronary syndromes and ECG and abnormal cardiac chambers pages have been updated with additional information about the significance of an inverted T wave in aVL
Modified Goldman score
A short segment describing the Modified Goldman score has been added to the Risk stratification in suspected ACS page.
Vancouver chest pain score
A short segment describing the Vancouver chest pain score has been added to the Risk stratification in suspected ACS page.
Clinical assessment of suspected ACS
The Clinical assessment of ACS page has been updated with revised information regarding LRs for ACS from the following article. Fanaroff, AC, Rymer, JA, Goldstein, SA, et al. Does This Patient With Chest Pain Have Acute Coronary Syndrome?: The Rational Clinical Examination Systematic Review. JAMA 2015;314(18):1955-65. http://www.ncbi.nlm.nih.gov/pubmed/26547467.
hsTnI
Additional information about hsTnI has been added to the Troponins in ACS page.
CXR in ACS
A short segment on the utility of routine CXR in patients with ACS has been added to the Management of acute coronary syndromes page.