How well do MACS, T-MACS and HE-MACS perform in emergency department patients with suspected cardiac chest pain? This appraisal examines a systematic review of their diagnostic accuracy, differences between study populations and the importance of external validation, while acknowledging the St Emlyn’s team’s involvement in developing the scores.
Systematic review of the Manchester Acute Coronary Scores. Read More
A 2021 appraisal of early CT coronary angiography for patients with suspected acute coronary syndrome. It examines a UK randomised trial’s patient outcomes, use of invasive angiography and limitations, asking whether routine CTCA is justified in this selected population.
JC: CTCA for cardiac chest pain in the ED. St Emlyn’s Read More
A friend’s experience of chest pain prompts this 2021 introduction to spontaneous coronary artery dissection. It explores presentation, diagnosis, management and life after SCAD, highlighting why few conventional cardiovascular risk factors should not obscure this important cause of myocardial infarction.
Spontaneous Coronary Artery Dissection (SCAD) Read More
Can an undetectable high-sensitivity troponin, a non-ischaemic ECG and clinical assessment speed safe discharge for chest pain? This 2020 LoDED trial appraisal examines its inconclusive primary comparison, variation in usual care and the limits of the safety data, keeping clinical judgement central.
JC: Are we fully LoDED? Read More
Ashley Liebig’s January 2020 introduction to the novel coronavirus outbreak, written as cases began appearing beyond China. The article records the early questions facing clinicians and the information available at that point, offering a historical snapshot rather than an up-to-date account of COVID-19.
2019 Novel Coronavirus (Wuhan) at St Emlyn’s Read More
How do T-MACS, HEART, TIMI and EDACS compare with a troponin-only strategy for suspected cardiac chest pain? This review examines a multicentre study using one high-sensitivity troponin I assay, balancing diagnostic sensitivity and rule-out efficiency against missing data and limits to generalisability.
Risk scores for cardiac chest pain: the first head-to-head comparison! Read More
George Willis discusses aortic emergencies in this recording from the inaugural St Emlyn’s Live conference in 2018. The introduction highlights diagnosis, medical management and pericardial effusion, with video, audio and further reading linked from the post.
Aortic Emergencies with George Willis at #stemlynsLIVE Read More
What should emergency clinicians ask when an adult with congenital heart disease attends the ED? This 2019 introduction explores altered anatomy, previous repairs and acute presentations, emphasising patients’ knowledge, specialist-team involvement and resources for further learning rather than offering a comprehensive management guide.
Adult Congenital Heart Disease in the Emergency Department Read More
