Articles in Cardiology (3)

Stratify pre-test probability using the Wells score or Geneva score. Low/intermediate risk: age-adjusted D-dimer. High probability: immediate CT pulmonary angiography (CTPA). Haemodynamically unstable (massive PE with SBP <90 mmHg): bedside echocardiography and systemic thrombolysis.

Acute total coronary occlusion presenting with crushing central chest pain and persistent ST-segment elevation in ≥2 contiguous ECG leads (or new LBBB with Sgarbossa concordance). Immediate management: dual antiplatelet therapy + primary PCI within 120 minutes (or fibrinolysis within 10 minutes if PCI unavailable).

Diagnostic requires ≥2 of 4 ESC criteria: (1) pericarditic chest pain relieved by sitting forward, (2) pericardial friction rub, (3) widespread concave ST elevation / PR depression on ECG, (4) new or worsening pericardial effusion. First-line therapy: high-dose NSAID + colchicine.