Thursday, November 24, 2011

Low Risk Chest Pain in the ED

I had a conversation with a few of the residents about the management of low risk chest pain in the Emergency Department. The issues which always seem to come up are:

  • If the first troponin is normal, can I send them home?
  • I don't think this is cardiac, let's just get one troponin and then send 'em home.
  • Okay fine, let's just do two sets and then send 'em home.

The patients which are obviously cardiac and obviously not cardiac are easy, but what about those ones in which there's some question?

There's a great review in Circulation from 2010 which discusses the management of low risk patients (click the link to get the article) and it's not all about cardiac risk factors.

If you're not into reading, then here are two short videos I made summarizing it. Let me know what you think and then we'll discuss it in the context of our patients during a shift.





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