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FACP. Colegio de médicos de Tarragona Nº 4305520 / fgcapriles@gmail.com

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sábado, 17 de septiembre de 2016

Chest Pain Controversies (Part 1)

emDocs - September 14, 2016 - Authors: Brit Long and Alex Koyfman - Edited by: Jamie Santistevan
"Summary
  • Missed ACS is a concern for patients and emergency providers.
  • Misdiagnosis and mismanagement of ACS accounts for a large percentage of lawsuits. However, the true rate of missing ACS approaches 0.2%.
  • Nonischemic ECG and negative biomarker at 0 hr and 3 hr reduces risk of MACE to less than 1%.
  • Further testing does not provide reassurance. Discussion with the patient of the assessment and follow up plan is needed.
  • Stress testing can be conducted with several modes and modalities which perform similarly, but these evaluations cannot further risk stratify patients to less than 1% risk.
  • Stress testing does not diagnose MI or ACS."