Cardiology

The opening day of badEMfest 2018 puts equality, advocacy and African-led solutions at the centre of emergency care. This report brings together discussions of traditional medicine, respectful transgender care, point-of-care ultrasound and resuscitation, asking how local context and unequal access shape what clinicians can achieve.

Should patients without ST elevation undergo early coronary angiography after cardiac arrest? This 2017 review examines mortality and neurological outcomes, then challenges the impressive apparent benefit by considering selection bias, retrospective studies and the limited randomised evidence available at the time.

The October 2017 podcast round-up revisits major incidents, thromboprophylaxis, oxygen in acute coronary syndromes and emerging cardiac biomarkers. It also reflects on the physical demands of EM training and the specialty’s annual scientific conference.

Could cardiac myosin binding protein C offer an alternative to troponin? This 2017 review examines promising diagnostic findings from APACE, while explaining why external validation, a practical assay and evidence of added clinical value were still needed.

Does routine oxygen improve outcomes in suspected acute coronary syndromes? This 2017 appraisal of DETO2X-SWEDEHEART examines its patient selection, unexpectedly low event rate and mortality findings, explaining why a non-significant result does not establish that two treatments are equivalent.

Could troponin tell us more than whether a patient has had an infarction? This 2017 reflection explores increasingly sensitive assays, cardiovascular risk and personalised baseline measurements, while distinguishing exciting possibilities from clinical benefits that still needed to be demonstrated.