R/O ACS

Even without a structured scoring system, clinicians may be able to combine troponin concentrations, EKG findings, and their own “gestalt” or clinical judgement to rapidly rule out ACS - Louise A. Cullen

R/O ACS

image by: Dr. mohammed.Gembry

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State-of-the-Art Evaluation of Emergency Department Patients Presenting With Potential Acute Coronary Syndromes

It is well established that clinicians cannot use clinical judgment alone to determine whether an individual patient who presents to the emergency department has an acute coronary syndrome. The history and physical examination do not distinguish sufficiently between the many conditions that can cause acute chest pain syndromes. Cardiac risk factors do not have sufficient discriminatory ability in symptomatic patients presenting to the emergency department. Most patients with non–ST-segment–elevation myocardial infarction do not present with electrocardiographic evidence of active ischemia. The improvement in cardiac troponin assays, especially in conjunction with well-validated clinical decision…

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 State-of-the-Art Evaluation of Emergency Department Patients Presenting With Potential Acute Coronary Syndromes

It is well established that the clinician cannot use clinical judgment alone to determine whether an individual patient who presents to the ED has an ACS. The improvement in cTn assays, especially in conjunction with clinical decision algorithms, now enables the clinician to rapidly exclude myocardial infarction.

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