I have a long history of complaining about guidelines and their seeming disregard for science and common sense. Therefore, when I sat down to read the most recent AHA guidelines on the evaluation and diagnosis of chest pain, I expected to be disappointed. Honestly, I was pleasantly surprised. It is […]
ACS
21 posts
I have dedicated a number of posts to the workup of low risk chest pain. There is the 5 part series demonstrating that our use of stress tests doesn’t make any sense. There is also a post demonstrating that CCTA has no role in these patients at this time. One […]
I hope to get back to normal emergency medicine literature sometime soon, but for now there is enough new COVID-19 research that I think another COVID specific research roundup is worthwhile. In this edition, I will tackle some more evidence that COVID can be spread by the airborne route, some […]
It’s time for another deep dive into the medical literature, this time looking at the evidence for heparin (or any anticoagulant) in the setting of STEMI and PCI. I have previously outlined the evidence that indicates that heparin shouldn’t be used (is harmful) in unstable angina and NSTEMI. However, that […]
Whenever you order a test, it is essential to know what you are going to do with the results. Tests, by themselves, cannot improve patient outcomes. Benefit can only occur if the test results in appropriate patients receiving a proven intervention.
There is no perfect study of stress testing. There are no RCTs of stress testing in emergency department patients, so we cannot say with certainty whether they help or hurt. The studies describing test characteristics are also imperfect. Partly, that is because people try to use stress tests to identify […]
