Multicenter analysis to assess risk of major adverse cardiac events in patients undergoing high-sensitivity troponin testing in the emergency department.

Study Hypothesis: Our objective was to evaluate 30-day major adverse cardiac events (MACE) in emergency department (ED) patients with normal high-sensitivity troponins (hs-trop). We hypothesized that MACE rates would be <1% in patients with (1) two normal troponins regardless of change in troponin (delta) and (2) index hs-trop below the limit of quantitation (LOQ) regardless of the institution modified HEART score.

Methods: This was a multicenter, retrospective, cohort study of adult patients who presented to 1 of 18 EDs between July 2020 and April 2021 with acute coronary syndrome as defined by an institutional-modified HEART score completed by their treating physician or midlevel, no evidence of ST-elevation myocardial infarction, and an index or serial gender-adjusted hs-trop within normal limits.

Case series demonstrating the value of computed tomography perfusion in differentiating ischemic strokes from seizures in patients with isolated aphasia.

The value of computed tomography perfusion (CTP) imaging in suspected stroke patients who are not candidates for mechanical thrombectomy is promising. This case series demonstrates how CTP imaging aided in distinguishing seizure from stroke in 5 patients who presented to the emergency department with acute onset of isolated aphasia.