
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 …

50 shades of black and white: the folly of dichotomy
In this quick post I’m hoping to get you thinking and asking questions about how we measure things in medicine. And I hope that, like me, it might change how you interpret information in your …

Emergency Medicine at 50: reflections on our progress
The Royal College of Emergency Medicine (RCEM) is celebrating a landmark in is history: the 50th birthday of UK Emergency Medicine. To mark this event, RCEM has been doing a number of things. There was …

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 …

Icatibant for ACE inhibitor induced angioedema
Patients presenting to the ED are tending to get older, have more co-morbidities and take more medications. As this happens, in my experience we seem to see more patients with complications of those medications. Something …

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 …

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 …

Dancing in the purple rain: lessons for clinicians from Prince
This year has been a tough one for the loss of celebrities. We’ve lost some great people. It doesn’t seem two minutes since the world was mourning the great David Bowie and now we hear …

JC: Why don’t we use dexamethasone for children’s asthma?
This post is written by Dr Niall Morris Prednisolone is about as tried and tested a treatment as we have in medicine. We all know how fantastic it is for settling down exacerbations of asthma. …