Cardiology

Rick Body discusses a 2014 study of emergency physicians’ judgement in suspected acute coronary syndromes. He explores the limitations of clinical judgement alone, the potential contribution of ECG and troponin results, and why promising findings still required validation before being used as a discharge strategy.

Could analysis of the ventricular fibrillation waveform help decide when to defibrillate? This 2014 appraisal examines a randomised trial in out-of-hospital cardiac arrest that found no improvement in survival, considering the study’s limitations and the gap between a plausible technology and demonstrated patient benefit.

A patient with ongoing chest pain has an ECG that does not fit a familiar STEMI pattern. This educational case from 2014 asks how the clinical history and shape of the ST segments should influence the next decision, before revealing the angiographic findings and outcome.

Rick Body introduces the original Manchester Acute Coronary Syndromes decision rule in this 2014 research report. He explains its derivation and external validation, how clinical features and biomarkers contribute to risk assessment, and the questions that still needed answering before routine use.

An illustrative chest-pain case challenges readers to interpret two ECGs alongside an early troponin result. This 2014 teaching post explores subtle high lateral STEMI, reciprocal changes and the risk of letting an initially unremarkable blood test distract from concerning ECG findings.

Does giving prasugrel before angiography help patients with non-ST-elevation acute coronary syndromes? This 2014 appraisal of ACCOAST examines the balance between ischaemic outcomes and major bleeding, alongside patient selection, the composite endpoint and the limits of applying the findings more widely.