High-sensitivity C-reactive protein (hs-CRP) is a key marker of inflammation, predominantly produced by hepatocytes and various tissues, including intracardiac tissue, atherosclerotic plaques, and vascular smooth muscles. The biomarker serves as a crucial element of innate immunity and rises in response to various disease processes, including infections and cancers. This rise…
Objectives: Cardiac troponin (cTn) measurement is useful for diagnosing myocardial infarction (MI), particularly in the inpatient setting. A growing body of literature suggests that cTn may be useful for evaluating chronic conditions in the outpatient environment; however, little is known regarding cTn ordering patterns in this setting. We sought to…
Objectives: Patients with an alcohol use disorder experiencing acute intoxication or withdrawal may be at risk for electrocardiograph (ECG) abnormalities, including prolongation of repolarization (long QTc [corrected QT]) that may contribute to arrhythmias and may be associated with a threefold increase in the likelihood of sudden cardiac events. Patients with…
Objectives: Radial artery access (RA) for left heart catheterization and percutaneous coronary interventions (PCIs) has been demonstrated to be safe and effective. Despite consistent data showing less bleeding complications compared with femoral artery access (FA), it continues to be underused in the United States, particularly in patients with acute coronary…
Choosing the appropriate stress test is important in the workup of patients with possible myocardial ischemia. This choice often is challenging and sometimes confusing because of the plethora of tests and guidelines available. We present a broad overview of commonly available stress tests and indications to help physicians select the…
A 45-year-old female athlete with no history of cardiovascular disease or coronary risk factors presented with a non–ST-segment elevation myocardial infarction due to spontaneous right coronary artery dissection. She was treated medically with resolution of her symptoms. Repeat angiography due to recurrent exertional chest discomfort showed TIMI-3 flow and no…
Background: Three percent of patients with acute myocardial infarction are still missed despite the excess number of admissions with chest pain. The purpose of this study was to review the characteristics of patients who were admitted with chest pain, to evaluate the appropriateness of admissions and the outcomes. We also…
Anaphylaxis, acute coronary syndrome and pulmonary embolism are conditions commonly seen in the acute medical setting which can be difficult to diagnose. Delay in establishing the correct diagnosis can result in either delayed or inappropriate treatment, and subsequent morbidity and mortality. The cases we present highlight the necessity of good…
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