Myocardial Infarction Rule-out in the Emergency Department: Are High-Sensitivity Troponins the Answer?

Newby, L. Kristin

doi:10.1001/archinternmed.2012.1808

Cited by 11 publications

(2 citation statements)

References 10 publications

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“…1 Triage of these patients has been called one of the most challenging of diagnostic dilemmas. 2 Recent advances in rapid diagnosis of ACS include the use of serial measurements of high-sensitivity cardiac troponin, 3 computed tomography, angiography, and diagnostic decision tools such as the Chest Pain Choice Decision Aid. 4 In addition, many EDs have established chest pain units with protocols for accelerated risk stratification, 5 and referral of low risk patients for outpatient stress testing.…”

Section: Introductionmentioning

confidence: 99%

Symptom clusters in patients presenting to the emergency department with possible acute coronary syndrome differ by sex, age, and discharge diagnosis

Rosenfeld¹,

Knight²,

Steffen³

et al. 2015

Heart & Lung

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Objectives To identify classes of individuals presenting to the ED for suspected ACS who shared similar symptoms and clinical characteristics. Background Describing symptom clusters in undiagnosed patients with suspected ACS is a novel and clinically relevant approach, reflecting real-world emergency department evaluation procedures Methods Symptoms were measured using a validated 13-item symptom checklist. Latent class analysis was used to describe symptom clusters. Results The sample of 874 was 37% female with a mean age of 59.9 years. Four symptom classes were identified: Heavy Symptom Burden (Class 1), Chest Symptoms and Shortness of Breath (Class 2), Chest Symptoms Only (Class 3), and Weary (Class 4). Patients with ACS were more likely to cluster in Classes 2 and 3. Women and younger patients were more likely to group in Class 1. Conclusions Further research is needed to determine the value of symptom clusters in the ED triage and management of suspected ACS.

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Section: Introductionmentioning

confidence: 99%

Symptom clusters in patients presenting to the emergency department with possible acute coronary syndrome differ by sex, age, and discharge diagnosis

Rosenfeld¹,

Knight²,

Steffen³

et al. 2015

Heart & Lung

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show abstract

“…The appropriate thresholds for various patient populations, the appropriate testing procedures with highsensitivity assays as compared with the fourthgeneration troponin assays (ie, frequency of testing, change in level, and rise), and the cost and clinical outcomes of care based on algorithms that use these values remain unclear and will require further study. 8,9 ■…”

Section: High-sensitivity Assaysmentioning

confidence: 99%

Third universal definition of myocardial infarction: Update, caveats, differential diagnoses

Tehrani¹,

Seto

2013

CCJM

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Updated definitions of myocardial infarction (MI) reflect research on measuring cardiac troponin to diagnose MI. Elevations of this biomarker indicate cardiac injury but not always an acute coronary syndrome. Clinical judgment is needed to interpret increasingly sensitive biomarker assays appropriately. Here, we review the new MI definitions and the various causes of elevated troponin to enable physicians to differentiate acute coronary syndromes from other conditions.

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One-hour rule-in and rule-out of acute myocardial infarction using high-sensitivity cardiac troponin I

Jaeger

Wildi

Twerenbold

et al. 2016

American Heart Journal

104

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Myocardial Infarction Rule-out in the Emergency Department: Are High-Sensitivity Troponins the Answer?

Cited by 11 publications

References 10 publications

Symptom clusters in patients presenting to the emergency department with possible acute coronary syndrome differ by sex, age, and discharge diagnosis

Symptom clusters in patients presenting to the emergency department with possible acute coronary syndrome differ by sex, age, and discharge diagnosis

Third universal definition of myocardial infarction: Update, caveats, differential diagnoses

One-hour rule-in and rule-out of acute myocardial infarction using high-sensitivity cardiac troponin I

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