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Acute Coronary Syndrome (our number one area of liability) [Part 2]
- Describing the character of the pain is the most common element of the history (Braunwald and Lee & Goldman).
- The history is the threshold issue and determines whether the patient enters risk stratification (Braunwald).
- The most atypical features of chest pain are sharp, pleuritic and positional pain.
- One-third of all patients with an MI have no chest pain.
- One set of cardiac enzymes violates a strong national standard of practice.
- Serial enzymes do not rule out unstable angina.
- If discharging a patient, document why you felt the patient did not have ACS.
- The plaintiff attorney literature advises litigators to focus on the history.