Table of Contents
From the Editor
- Identifying and classifying myocardial infarctions
In this issue of the Journal, Drs. Shaun Senter and Gary Francis discuss the power of electrocardiographic changes and creatine kinase-MB and troponin elevations in diagnosing acute myocardial infarction. These are not perfect tests.
The Clinical Picture
- Unilateral cotton wool spots: An important clue
The patient has sudden loss of vision in one eye and unilateral cotton wool spots on funduscopy. What is the cause?
Review
A new, precise definition of acute myocardial infarctionThe updated definition includes subtypes of acute MI, imaging studies supporting the diagnosis, and biomarker thresholds after percutaneous coronary intervention and coronary artery bypass grafting.
- Psychiatric symptoms of dementia: Treatable, but no silver bullet
Your 84-year-old patient’s son is distraught. “I know Mom has dementia, but I don’t understand why she cannot relax. Please give her a pill.”
Imaging in Practice
- The radiologic workup of a palpable breast mass
The discovery of a breast mass is a common occurrence, and it is distressing for any woman. The choice of initial imaging study is most often guided by the patient’s age.
Review
- Optic neuritis and risk of MS: Differential diagnosis and management
Optic neuritis, a demyelinating inflammatory condition that causes acute vision loss, is associated with multiple sclerosis. Recognizing its classic clinical manifestations early is important so that diagnostic testing and treatment can be started.
Im Board Review
- A 43-year-old woman with chest pressure
She has acute chest discomfort, a 25-pack-year smoking history, and a family history of myocardial infarction and deep vein thrombosis. What is the cause of her symptoms?
Cardiovascular Board Review
- A 37-year-old man with chest pain, ECG changes, and elevated cardiac enzymes
He has had chest pain and dyspnea for the past few months, but now they are worse. What is the most likely cause?
