Acute Coronary Syndromes

Acute Coronary Syndromes

Troponin and biotin: a lethal combination?

Imagine you’re treating a patient who presented with typical cardiac chest pain. The initial ECG showed subtle lateral ST depression that seemed to resolve on subsequent ECGs. You’re very concerned by the clinical picture and believe that ACS is the…
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#badEMfest18 Day 1. St Emlyn’s

Last week the St Emlyn’s team in the form of Janos Baombe, Natalie May, Ross Fisher and myself travelled to Greyton for the very first #badEMfest18. This is a conference with a real difference. Set out on a farm about…
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Is cMyC the new troponin?

Anyone who reads the news is likely to have seen the recent paper in Circulation evaluating a new biomarker of acute coronary syndromes: cardiac myosin binding protein C (cMyC) . This paper has been covered by the BBC, the Telegraph…
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JC: Oxygen in ACS. A fuss about nothing? The DETO2X Trial at St.Emlyn’s

DETO2X-SWEDEHEART sounds like a new low-carb, high-alkali, So-Cal diet plan but it is actually a trial exploring the affect of oxygen on mortality in patients with a suspected acute coronary syndrome (ACS). There is a striking similarity tenuous link between…
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JC: Cardiac arrest centres and bypass. St.Emlyn’s

The concept of cardiac arrest centres is not entirely new and is something we’ve been talking about in Virchester for some time. Indeed, there are several articles in the literature and a fairly reasonable patho-physiological argument for them1–3. We know…
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One high sensitivity troponin test to rule out acute myocardial infarction

This month I was honoured that a study I wrote with some terrific colleagues from Europe, Australia and the US has been published as the ‘Editor’s Choice’ in Academic Emergency Medicine. This was a secondary analysis from a large, multi-centre, international…
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Life and Learning from Rob Rogers on the other side of that ECG. St.Emlyn’s

Last week I was  wandering through Amsterdam when I came across a tweet which stopped me in my tracks. A real game changer, a shock, a wake up call and a surprise. Rob Rogers (aka @EM_Educator) tweeted a really interesting…
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Cardiology Case 05: Detective work

  It’s been a while since we shared a cardiology case but here’s a cracker for you. As usual, see our Caveats and Cautions. While these cases are based on our genuine experiences (often pooling several experiences), we always alter details…
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