FOAMcast - Emergency Medicine Core Content

We cover the clinical policy from the American College of Emergency Physicians - Clinical Policy: Critical Issues in the Evaluation and Management of Emergency Department Patients With Suspected Non–ST-Elevation Acute Coronary Syndromes

In adult patients without evidence of ST-elevation acute coronary syndrome, can initial risk stratification be used to predict a low rate of 30-day major adverse cardiac events?

  • Use HEART score ≤3 

In adult patients with suspected acute non–ST-elevation acute coronary syndromes, can troponin testing within 3 hours of emergency department presentation be used to predict a low rate of 30-day major adverse cardiac events?

  • Negative conventional troponins at 0,3 hrs in low risk patients
  • High sensitivity troponin: undetectable initial troponin, no need for another. Negative initial troponin, repeat at 2 hours

In adult patients with suspected acute non–ST-elevation acute coronary syndromes in whom acute myocardial infarction has been excluded, does further diagnostic testing (eg, provocative, stress test, computed tomography [CT] angiography) for acute coronary syndrome prior to discharge reduce 30-day major adverse cardiac events?

  • No need to get provocative testing before discharge or within particular time frame

Should adult patients with acute non–ST-elevation myocardial infarction receive immediate antiplatelet therapy in addition to aspirin to reduce 30-day major adverse cardiac events?

  • antiplatelet therapy additional to aspirin can be given or delayed

Thanks for listening!
Jeremy Faust and Lauren Westafer

Direct download: FOAMcast_ACS_ACEP_guideline_with_definition_fix.mp3
Category:general -- posted at: 2:12pm EDT

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