Optimizing Diagnosis and Treatment of Chest Pain

Here is the follow-up to the mammoth ACS chapter. This one has some key factoids to put into your mind map / memory pallace / organic computer.

1. List Sgarbossa criteria for AMI in pre-existing LBBB
2. What is Takotsubo cardiomyopathy and how does it present?
3. Describe the kinetics of cardiac biomarkers (Troponins and CK)
4. List DDx for ↑ Troponin
5. What is the utility of CTA in the diagnosis of MI?
6. What is the role of ED-based chest pain centers?
7. List 3 phases of delay in the management of AMI; and describe the time-points in ED management of AMI.
8. What are door-to-needle and door-to-balloon timelines by AHA recommendations?
9. Describe the mechanism of action and indications/contraindications for
   1. Nitroglycerin
   2. Morphine
   3. BBlockers
   4. ACE-I
   5. Antiplatelet Therapies
   6. Anti-thrombins
10. Describe eligibility criteria for Fibrinolytics
11. List contraindications to Fibrinolytic therapy in MI
12. What is the utility of Rescue PCI and Facilitated PCI?
13. List 5 indications for Rescue PCI
14. Describe factors assisting with decision to utilize PCI or thrombolytics
15. In NSTEMI, who will benefit from an early invasive strategy of management?

Wise Cracks:

1. What is the HEART Score?
2. What is the management of ACS in the setting of recent cocaine use?
3. How is STEMI diagnosed in the setting of LBBB?
4. How is STEMI diagnosed in the setting of a ventricular pacemaker?
5. When should you be getting a 15 lead ECG?