CAP7 Archives • Page 3 of 6 • St.Emlyn's

JC: High sensitivity Troponin I on presentation. Is it enough to rule out ACS? St.Emlyn’s

By Simon Carley / November 27, 2015

Could a single high-sensitivity troponin I result help rule out acute coronary syndrome at presentation? This 2015 appraisal examines a diagnostic cohort study, distinguishing negative predictive value from sensitivity and asking how the findings fit with ECG interpretation, clinical risk and different patient populations.

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JC: Are typical chest pain symptoms predictive of outcome? St.Emlyn’s

By Simon Carley / May 18, 2015

How much does describing chest pain as ‘typical’ tell us about the final diagnosis? Simon Carley reviews a 2015 observational study of clinician judgement, questioning the value of experience alone and examining how patient selection, specificity and the presentation of diagnostic performance affect interpretation.

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Good times part 1: DIDO-30 for STEMI

By Rick Body / April 3, 2015

How can emergency departments reduce delays for patients who need transfer for primary PCI? This 2015 account of Manchester’s DIDO-30 project examines early ECG recording, recognition and escalation, with practical ideas for improving pathways through staff feedback, shared responsibility and rehearsing the whole process.

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The MACS rule: a new user-friendly version

By Rick Body / January 28, 2015

Could an automated blood test make the original MACS chest pain rule practical to use? This 2015 research update explains validation with a new heart-type fatty acid binding protein assay, how the rule was recalibrated and why testing its effects in clinical practice was the next step.

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Is severe chest pain more likely to be a heart attack?

By Rick Body / December 4, 2014

Does more severe chest pain make a heart attack more likely? Rick Body describes a 2014 study of emergency department patients, showing the difference between a statistically significant association and a useful diagnostic test, and why mild discomfort alone cannot provide reassurance about the underlying cause.

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New NICE high sensitivity troponin guidance: 3 hours and done?

By Rick Body / October 25, 2014

Rick Body examines NICE’s 2014 recommendations on high-sensitivity troponin testing for early exclusion of NSTEMI. The article and podcast explain the guidance’s limited assay-specific scope, the distinction between excluding infarction and deciding on discharge, and the practical challenge of fitting repeat testing into emergency department workflows.

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The Heart Under Stress – St. Emlyn’s at SMACC Gold

By Rick Body / September 3, 2014

Rick Body introduces his SMACC Gold 2014 talk, ‘The Heart Under Stress’, on using history, examination and troponin testing when assessing possible acute coronary syndrome. The accompanying post also reflects on turning research into an engaging conference presentation, with storytelling and humour alongside the clinical discussion.

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The Troponin Ashes at SMACC Gold: Cullen v Body

By Rick Body / August 24, 2014

Louise Cullen and Rick Body debate whether high-sensitivity troponin is friend or foe at SMACC Gold 2014. This post brings together the recording, both speakers’ slides and background resources on troponin interpretation, including why a raised concentration does not always mean acute myocardial infarction.

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