A selection of resources

Myocardial Infarct; diagnosis

To rule out low risk

Can use single troponin

Think occlusion MI rather than STEMI

Acceptable “miss” thresholds for rule out criteria.

Diagnosis MI

The guidelines

NICE obviousily have lots of guidelines around this, I particularly like their “do not” guides which advises against excessive oxygen and for using GTN response as a diagnosis marker. The main NICE guide from 2019 also suggests you can use a single rule out troponin

I find the NICE guidelines a little sparse. The european society of cardiology has much more detailed guidelines.


Diagnosis MI

The FOAM Resources

Some of the finest free to access resources out there

St Emlyn’s

Summary of paper comparing HEART to other scores.

Dr smith’s ecg blog

The most detailed analysis of ecg out there, presented as clinical cases; if you thought you understood ischaemic change, you didn’t

Life in the fast lane

Everyone knowns LITFL as the best compendium of ecg. This discussion of RV infarct is particularly helpful

emdocs

Summary of ECG resources

Critical care canada

Some sides of guide to diagnosis and management of RV infarct

Diagnosis myocardial infarction

Some useful papers

An open access meta-analysis comparing recognised MI’s to those diagnosis later

I may be massively misinterpreting this study, but they seem to conclude mortaility outcomes are the same whether you diagnosis an MI or not?

This useful paper suggesting that can get away without troponin for the very low risk group.