Heart attack equipoise

Thumb_Emergency

Musings on the point of equipoise for investigating and discharging chest pain patients in light of a new paper in the Lancet describing a rapid rule-out protocol for acute coronary syndromes (the ASPECT trial).

EBM Chest Pain Adjunctive Therapies

Chest pain

EBM review of Chest Pain Adjunctive Therapies including adjunctive anticoagulant therapy, adjunctive anti-thrombotic therapy and other therapeutic agents

EBM Chest Pain Management

Chest pain

EBM Chest Pain Management including early Management of STEMI or NSTEACS, reperfusion strategies, percutaneous coronary intervention (PCI) and thrombolysis

EBM Chest Pain

Chest pain

Chest Pain and risk stratification – EBM Review. Coronary heart disease single largest cause of death (16% or 27,000) in 2007 in Australia, but down from 22% in 1998.

Puzzling out the PERC rule

A patient has chest pain and shortness of breath. Is there a way to rule out pulmonary embolism without further investigation? Can you use the PERC rule?

DeBakey’s Dissection

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A previously well 50 year old presents with sharp severe chest pain after a long haul flight from North America. A chest X-ray and ECG are performed and reveal no abnormalities