Re: e-discussion on Emerging trends in therapeutics of ACS [1 Attachment]

[Guest guest]

Nice introductory discussion by Tarun. However, I would like to highlight few words of caution in interpreting pain and ECG in suspected ACS. 1) Never rely on symptoms. Certain characteristic of pain e.g. left side with radiation to arm, has high like hood of having ACS but it neither excludes or includes ACS with certainty. 2) Pain is a symptoms which is highly variable and depend upon the perception/ threshold of a person and never try to judge ACS based on severity of pain. 3) Specific population like old aged and diabetics may not have pain at all and sometimes called silent ACS.

4) Interpretation of ECG is an art which can be learned by experience. ECG may be normal with classical pain of ACS and abnormal ECG without any pain. furthermore, 10% of diabetics may have minor ischemic changes on ECG which are reversible spontaneously with time. Regards,Dr. Viral Shah MBBS, MD, FCCP, DM (running)Senior Resident,Department of Endocrinology,Postgraduate Institute of Medical Education & ResearchSector-12, Chandigarh PIN- 160 012, INDIA.Mobile- 09872308785. Mail: viralshah_rational@... drshahviral@... From: tarun wadhwa <pharma_tarun@...>NetRum <netrum >Sent: Monday, 18 July 2011 8:59 PMSubject: e-discussion on "Emerging trends in therapeutics of ACS" [1 Attachment]

Dear Members,Clinical Presentation:Please find the attached document herewith.Regards,Tarun Wadhwa