Top

Published in:

01-11-2019 | Resting ECG | Exercise in Clinical Reasoning

A Stressful Situation

Authors: Joseph Rencic, MD, Mark C. Henderson, MD, John Wong, MD, Eric Cantey, MD, Richard Kopelman, MD

Published in: Journal of General Internal Medicine | Issue 11/2019

Excerpt

In this series a clinician extemporaneously discusses the diagnostic approach (regular text) to sequentially presented clinical information (bold). Additional commentary on the diagnostic reasoning process (italic) is interspersed throughout the discussion. …

Genders TSS, Steyerberg EW, Alkadhi H, Leschka S, Desbiolles L, Nieman K, et al. The CAD Consortium. A clinical prediction rule for the diagnosis of coronary artery disease: validation, updating and extension. Eur Heart J. 2011,32:1316–1330.CrossRef

Poses RM, et al. The accuracy of experienced physicians’ probability estimates for patients with sore throats: implications for decision making. JAMA. 1985;254(7): 925–29.CrossRef

Redelmeier DA. Improving patient care. The cognitive psychology of missed diagnoses. Ann Intern Med. 2005;142(2):115–20.CrossRef

Mahmoodzadeh S, Moazenzadeh M, Rashidinejad H, Sheikhvatan M. Diagnostic performance of electrocardiography in the assessment of significant coronary artery disease and its anatomical size in comparison with coronary angiography. J Res Med Sci. 2011;16(6):750–755.PubMedPubMedCentral

Pauker SG, Kassirer JP. The threshold approach to clinical decision making. N Engl J Med. 1980;302(20):1109–17.CrossRef

Garber AM, Solomon NA. Cost-effectiveness of alternative test strategies for the diagnosis of coronary artery disease. Ann Intern Med. 1999;130(9):719–28.CrossRef

Underwood SR, Anagnostopoulos C, Cerqueira M, et al. Myocardial perfusion scintigraphy: the evidence. Eur J Nucl Med Mol Imaging. 2004;31:261–91.CrossRef

Shaw LJ, Peterson ED, Shaw LK, Kesler KL, DeLong ER, Harrell FE, Muhlbaier LH, Mark DB. Use of a prognostic treadmill score in identifying diagnostic coronary disease subgroups. Circulation. 1998;98(16):1622–30.CrossRef

Stacey D, Légaré F, Col NF, Bennett CL, Barry MJ, Eden KB, et al. Decision aids for people facing health treatment or screening decisions. Cochrane Database Syst Rev 2014;(1):CD001431. https://doi.org/10.1002/14651858.CD001431.pub4.

10.

Barry MJ, Edgman-Levitan S. Shared Decision Making — The Pinnacle of Patient-Centered Care. New Engl J Med 2012; 366(9):780–1.CrossRef

11.

Walsh MN, Bove AA, Cross RR, Ferdinand KC, Forman DE, Freeman AM, et al. ACCF 2012 Health policy statement on patient-centered care in cardiovascular medicine: a report of the American College of Cardiology Foundation Clinical Quality Committee. J Am Coll Cardiol 2012;59(23):2125–43CrossRef

12.

Botros J, Rencic J, Centor RM, Henderson MC. Anchors away. J Gen Intern Med. 2014;29(10):1414–8.CrossRef

13.

Kassirer JP. Our stubborn quest for diagnostic certainty: a cause of excessive testing. NEJM.2010;320(22): 14890–1491.

14.

Cannon CP, Weintraub WS, Demopoulos LA, Vicari R, Frey MJ, Lakkis N, Neumann FJ, Robertson DH, DeLucca PT, DiBattiste PM, Gibson CM. Comparison of early invasive and conservative strategies in patients with unstable coronary syndromes treated with the glycoprotein IIb/IIIa inhibitor tirofiban. New Engl J Med. 2001;344(25):1879–87.CrossRef

15.

Mark DB, Shaw L, Harrell F, Hlatky M, Lee K, Bengston JR, et al. Prognostic value of a treadmill exercise score in outpatients with suspected coronary artery disease. N Engl J Med 1991;325(12):849–53.CrossRef

16.

Poornima IG, Miller T, Christian T, Hodge D, Bailey KR, Gibbons RJ. Utility of myocardial perfusion imaging in patients with low-risk treadmill scores. J Am Coll Card 2004;43(2):194–199.CrossRef

17.

McGee SR. Evidence-based physical diagnosis, 3rd ed. Philadelphia, Elsevier Health Sciences, 2012.

Title: A Stressful Situation
Authors: Joseph Rencic, MD
Mark C. Henderson, MD
John Wong, MD
Eric Cantey, MD
Richard Kopelman, MD
Publication date: 01-11-2019
Publisher: Springer US
Keywords: Resting ECG
Resting ECG
Gastroesophageal Reflux Disease
Published in: Journal of General Internal Medicine / Issue 11/2019
Print ISSN: 0884-8734
Electronic ISSN: 1525-1497
DOI: https://doi.org/10.1007/s11606-019-05085-5

ACC 2024 Congress Coverage

Heart Failure Video

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

A Stressful Situation

Excerpt

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Excerpt

Please log in to get access to this content

Other articles of this Issue 11/2019

Association Between Medicaid Expansion Under the Affordable Care Act and Medicaid-Covered Pre-emptive Kidney Transplantation

A Systematic Review of Advocacy Curricula in Graduate Medical Education

Benefits and Harms of Mammography Screening for Women With Down Syndrome: a Collaborative Modeling Study

Would You Be Surprised If This Patient Died This Year? Advance Care Planning in Substance Use Disorders

A Toolbox Approach to Obesity Treatment in Urban Safety-Net Primary Care Clinics: a Pragmatic Clinical Trial

Implementing Motivational Interviewing for Substance Misuse on Medical Inpatient Units: a Randomized Controlled Trial

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page