What does ‘high sensitivity’ actually mean when describing a troponin assay? This 2014 explainer and accompanying podcast unpack detection limits, precision and the distinction between analytical and diagnostic sensitivity, while exploring why more sensitive tests still require careful clinical interpretation.
High sensitivity troponin Read More
A 2014 introduction to cardiac troponin, built around common questions from the emergency department. The post introduces Rick Body and Iain Beardsell’s podcast on interpreting results, including causes of elevation, timing, changes between samples and the complications posed by renal failure.
Cardiac Troponin: The basics from St. Emlyn’s Read More
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.
How accurate is clinical judgement for acute coronary syndromes? Read More
What place should chronic disease risk factors have in emergency decision-making? Simon Carley introduces his SMACC Gold presentation, using that question to explore how clinicians’ assumptions, interpretations and beliefs influence their assessment of patients in the emergency department and resuscitation room.
Do risk factors factor in the ED? St.Emlyn’s at #SMACC Gold Read More
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.
Cardiology Case 04: An unusual ECG Read More
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.
The MACS Rule: Immediate ‘rule in’ and ‘rule out’ for suspected cardiac chest pain Read More
How do the many tools for investigating and treating pulmonary embolism fit into one coherent pathway? This 2014 discussion explores the challenge of combining diagnostic rules, risk assessment and outpatient care, as work began on British Thoracic Society guidance for ambulatory management.
Ambulatory PE: A walk in the park? St.Emlyn’s Read More
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.
Cardiology Case 03: Are you missing the STEMI? St. Emlyn’s Read More
