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Table of Contents
Intro; Preface; Contents; Contributors; Chapter 1: Chest Pain in the ER; 1.1 The Scope of the Problem; 1.2 Prevalence; 1.3 High-Clinical Suspicion for Cardiac-Related Causes of CP in the ER; 1.4 Chest Pain and Risk Factors for Acute Coronary Syndromes; 1.4.1 Pathophysiology; 1.4.2 Clinical Presentation; 1.4.3 Physical Examination; 1.4.4 Electrocardiogram; 1.4.4.1 Acute Coronary Syndromes; 1.4.4.2 Pulmonary Embolism; 1.4.4.3 Pericarditis and Pericardial Tamponade; 1.4.4.4 Acute Aortic Dissection; 1.5 Imaging Studies; 1.5.1 Chest X-ray; 1.5.1.1 Acute Coronary Syndromes
1.5.1.2 Acute Aortic Dissection1.5.1.3 Acute Pulmonary Embolism; 1.5.2 Echocardiogram; 1.5.3 Immediate Exercise Stress Echocardiogram; 1.5.4 Cardiac Computed Tomography (CCT) and Other Imaging Tests; 1.6 Laboratory Evaluation; 1.6.1 Cardiac Biomarkers in the Context of Acute Coronary Syndromes; 1.6.2 Differential Diagnosis; 1.6.3 Clinical Approach; 1.7 Additional Clinical Practice Takeaway; References; Chapter 2: Dyspnea in the ER; 2.1 The Scope of the Problem; 2.2 Prevalence; 2.3 High-Clinical Suspicion for Dyspnea of Cardiac Origin; 2.3.1 Pathophysiology; 2.3.2 Clinical Presentation
2.3.3 Dyspnea Approach2.3.4 Physical Examination; 2.3.5 Electrocardiogram; 2.4 Imaging Diagnosis Approach; 2.4.1 Chest X-Ray; 2.4.2 Echocardiogram; 2.4.3 Cardiac Computed Tomography; 2.4.4 Ventilation/Perfusion Lung Scan; 2.5 Laboratory Evaluation; 2.5.1 Cardiac Biomarkers; 2.5.2 Differential Diagnosis; 2.6 Additional Clinical Practice Takeaway; References; Chapter 3: Suspected Cardiovascular Syncope in the ER; 3.1 The Scope of the Problem; 3.2 Prevalence; 3.3 Syncope Risk Factors; 3.4 Pathophysiology; 3.5 Clinical Presentation; 3.5.1 Presyncope; 3.5.2 Syncope
3.5.3 Main Clinical Characteristics3.5.3.1 Physical Examination; 3.5.3.2 Electrocardiogram; 3.5.4 Risk Stratification; 3.6 Multimodal Diagnosis Approach; 3.7 Laboratory Evaluation; 3.7.1 Differential Diagnosis of Cardiac Syncope; 3.8 Treatment; 3.8.1 Neurally Mediated Syncope; 3.8.2 Orthostatic Hypotension; 3.8.3 Cardiac Syncope; 3.9 Additional Clinical Practice Takeaways; References; Chapter 4: Optimizing the Use of Biomarkers in the ER; 4.1 Introduction; 4.2 The Scope of the Problem; 4.2.1 Pre-analytical Operating Characteristics; 4.2.2 Analytical Operating Characteristics
4.2.3 Clinical Operating Characteristics4.2.4 Principles for the Proper Use of Cardiac Biomarkers at the ER; 4.3 Cardiac Troponins; 4.3.1 Physiology; 4.3.2 Pre-analytical Considerations; 4.3.3 Analytical Characteristics; 4.3.4 Clinical Relevance; 4.3.5 Clinical Conditions Associated with Increased Expression of cTn; 4.3.6 Diagnostic Algorithms and Prediction Scores; 4.3.7 Foresight, Challenges, and Limitations at the ER; 4.4 Natriuretic Peptides, Cardiac Stress, and Heart Failure; 4.4.1 Physiology; 4.4.2 Pre-analytical Considerations; 4.4.3 Analytical Characteristics; 4.4.4 Clinical Relevance
4.4.5 Clinical Conditions Associated with Increased Expression of NP
1.5.1.2 Acute Aortic Dissection1.5.1.3 Acute Pulmonary Embolism; 1.5.2 Echocardiogram; 1.5.3 Immediate Exercise Stress Echocardiogram; 1.5.4 Cardiac Computed Tomography (CCT) and Other Imaging Tests; 1.6 Laboratory Evaluation; 1.6.1 Cardiac Biomarkers in the Context of Acute Coronary Syndromes; 1.6.2 Differential Diagnosis; 1.6.3 Clinical Approach; 1.7 Additional Clinical Practice Takeaway; References; Chapter 2: Dyspnea in the ER; 2.1 The Scope of the Problem; 2.2 Prevalence; 2.3 High-Clinical Suspicion for Dyspnea of Cardiac Origin; 2.3.1 Pathophysiology; 2.3.2 Clinical Presentation
2.3.3 Dyspnea Approach2.3.4 Physical Examination; 2.3.5 Electrocardiogram; 2.4 Imaging Diagnosis Approach; 2.4.1 Chest X-Ray; 2.4.2 Echocardiogram; 2.4.3 Cardiac Computed Tomography; 2.4.4 Ventilation/Perfusion Lung Scan; 2.5 Laboratory Evaluation; 2.5.1 Cardiac Biomarkers; 2.5.2 Differential Diagnosis; 2.6 Additional Clinical Practice Takeaway; References; Chapter 3: Suspected Cardiovascular Syncope in the ER; 3.1 The Scope of the Problem; 3.2 Prevalence; 3.3 Syncope Risk Factors; 3.4 Pathophysiology; 3.5 Clinical Presentation; 3.5.1 Presyncope; 3.5.2 Syncope
3.5.3 Main Clinical Characteristics3.5.3.1 Physical Examination; 3.5.3.2 Electrocardiogram; 3.5.4 Risk Stratification; 3.6 Multimodal Diagnosis Approach; 3.7 Laboratory Evaluation; 3.7.1 Differential Diagnosis of Cardiac Syncope; 3.8 Treatment; 3.8.1 Neurally Mediated Syncope; 3.8.2 Orthostatic Hypotension; 3.8.3 Cardiac Syncope; 3.9 Additional Clinical Practice Takeaways; References; Chapter 4: Optimizing the Use of Biomarkers in the ER; 4.1 Introduction; 4.2 The Scope of the Problem; 4.2.1 Pre-analytical Operating Characteristics; 4.2.2 Analytical Operating Characteristics
4.2.3 Clinical Operating Characteristics4.2.4 Principles for the Proper Use of Cardiac Biomarkers at the ER; 4.3 Cardiac Troponins; 4.3.1 Physiology; 4.3.2 Pre-analytical Considerations; 4.3.3 Analytical Characteristics; 4.3.4 Clinical Relevance; 4.3.5 Clinical Conditions Associated with Increased Expression of cTn; 4.3.6 Diagnostic Algorithms and Prediction Scores; 4.3.7 Foresight, Challenges, and Limitations at the ER; 4.4 Natriuretic Peptides, Cardiac Stress, and Heart Failure; 4.4.1 Physiology; 4.4.2 Pre-analytical Considerations; 4.4.3 Analytical Characteristics; 4.4.4 Clinical Relevance
4.4.5 Clinical Conditions Associated with Increased Expression of NP