The Clinical Problem Solvers Episode 367: Schema Episode – Acute Coronary Syndrome
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Nov 28, 2024 Curious about the world of acute coronary syndrome? The hosts break down a fascinating case study involving heartburn and cardiac concerns in an elderly patient, emphasizing the need for careful evaluation. They dive into the intricacies of EKG interpretation and the significance of elevated troponin levels. Additionally, personal anecdotes reflect on their journeys, highlighting the importance of support in stressful times. With insights into the multidisciplinary approach to treatment, this discussion is a deep dive into both medical challenges and personal reflections.
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Reframing GERD in Older Adults
- Consider underlying causes like malignancy or strictures in older patients with worsening GERD.
- Reframe GERD as chest pain if symptoms are exertional and unresponsive to antacids, especially in older adults.
CAD and EKG Importance
- Coronary artery disease (CAD) is a serious concern in patients with exertional chest pain and cardiac risk factors.
- Look for signs of coronary occlusion on EKG immediately, as troponin elevation takes time.
Elevated Troponin and BNP
- Approach elevated troponin in tiers: decreased supply, increased demand, then non-vascular causes.
- Elevated BNP suggests heart failure, especially with additional signs like pitting edema.