Emergency medicine
Acute chest pain in the emergency department: the first ten minutes, high-sensitivity troponin, the reperfusion decision in STEMI, and telling a STEMI from an aortic dissection.
5:21Chest pain approach: the first 10 minutes
A simple chest pain approach for any adult with acute chest pain: a three-rung ladder of stability, a 12-lead ECG within 10 minutes with the six life threats, then troponin and risk.
5:23High-sensitivity troponin: myocardial injury vs infarction
How to use high-sensitivity troponin in suspected ACS without ST elevation: serial ECGs, the repeat sample and the rise or fall, and how myocardial injury differs from myocardial infarction.
5:18STEMI vs NSTEMI: the reperfusion decision
Same crushing chest pain, two different ECGs. One sends the patient for reperfusion within minutes; the other starts a risk assessment. Here is how to tell them apart and what to do first.
4:44Chest pain next best step: STEMI or aortic dissection?
Inferior ST elevation meets STEMI criteria, but the rest of the stem points somewhere else. Walk a chest pain case line by line and see why the next best step is to image the aorta.