Wardround 07x05

This week’s two minute tutorials were about acute coronary syndrome. The risk stratification talk has been podcasted and is available as an audioblog in the post below this. Naveen and Dilshad gave us brief updates on beta blockers and heparin in ACS. I will ask them to post something in the comments.

If you want a brief review of ACS treatment have a look at Treating non-ST-segment elevation ACS: Pros and cons of current strategies. Enrique V. Carbajal, MD; Prakash Deedwania, MD
VOL 118 / NO 3 / SEPTEMBER 2005 / POSTGRADUATE MEDICINE

Or Unstable Angina and NSTEMI:Tailoring Treatment Based on Risk. Eve Kaiyala, MD, and Deborah B. Diercks, MD. Emerg Med 36(11):20-38, 2004

We did not get chance to discuss the The practice of clinical medicine as an art and as a science paper today but I will expect some comments over coffee on Tuesday.

The reading for next week is:

ACC/AHA 2002 Guideline Update for Exercise Testing
http://www.acc.org/clinical/guidelines/exercise/dirindex.htm

Integration of the complete contents into your brain is not required…the task is to gain some useful information to allow you to better report and interpret a test you perform on a patient with known IHD. Discuss..

Interesting cases this week:

Pericardial effusion and cancer
Pericardial effusion in patients with cancer: outcome with contemporary management strategies. RJ Laham, DJ Cohen, RE Kuntz, DS Baim, BH Lorell and M Simons Heart, 1996;75: 67-71, http://heart.bmjjournals.com/cgi/content/abstract/75/1/67

Acute Monoarthritis
http://www.rheumatology.org/publications/guidelines/musc/musc-dis.asp

Haemolysis – Cold agglutinins
http://www.emedicine.com/med/topic408.htm
Uptodate has a good article as well


Don’t forget your two minute tutorials…make them concise and precise.
The theme next week will be the normal ecg… when you say “the ECG is normal”, what does this actually mean (or what should it mean)?

MJM P wave and PR interval
Dr Mohan QRS
Dr Kidder T wave and ST segment
Dr Jones Axis (and by special request the QT interval) (I’ll bet she even manages to sneak some infectious disease stuff into this!)


If anyone out there would like to submit two minute tutorials for the podcast, just leave me a note in one of the comments.