A patient presenting to the ER by chest pain.
Is his pain possibly of cardiac or non-cardiac origin?
Is he considered STEMI or NSTE-ACS?
Do we need to measure cardiac troponin?
What about doing CT coronaries if ECG & troponin are negative?
0:00 Intro
0:37 ACS spectrum
2:10 Fourth Universal Definition of MI
3:12 Working Diagnosis of STEMI vs. NSTE-ACS
6:28 Specific Definitions
10:35 Clinical Presentation
15:13 Risk Stratification
15:56 ECG
18:26 Cardiac Troponin
28:35 Non-invasive Imaging
2023 ESC Guidelines for the Management of Acute Coronary Syndromes
www.escardio.org/Guidelines/C...
2023 ESC Guidelines for the management of acute coronary syndromes Supplementary data
oup.silverchair-cdn.com/oup/b...
BEACON trial. Coronary CT Angiography for Suspected ACS in the Era of High-Sensitivity Troponins: Randomized Multicenter Study
pubmed.ncbi.nlm.nih.gov/26764...
ROMICAT-II trial. Coronary CT Angiography versus Standard Evaluation in Acute Chest Pain
www.nejm.org/doi/full/10.1056...
RAPID-CTCA trial. Rapid Assessment of Potential Ischaemic Heart Disease with CTCA) - a multicentre parallel-group randomised trial to compare early computerised tomography coronary angiography versus standard care in patients presenting with suspected or confirmed acute coronary syndrome: study protocol for a randomised controlled trial.
pubmed.ncbi.nlm.nih.gov/27923...