#35 Acute Coronary Syndrome and TIMI Risk Score: Mind the Gap Segment

Core IM | Internal Medicine Podcast

Core IM Team

Mental Health, Education, Health & Fitness, Medicine

4.8 • 1K Ratings

🗓️ 27 February 2019

⏱️ 22 minutes

🔗️ Recording | iTunes | RSS

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Summary

Let's go deeper into the world of ACS and the origin of the TIMI score and major adverse cardiac events "MACE" outcomes! * The basics – what is acute coronary syndrome? (4:08) * Clinical context matters – angina pectoris, atypical chest pain, and troponins (5:22) * You can’t just “cath” everyone – risk stratification to identify patients with high mortality risk (9:42) * TIMI isn’t perfect – the issues with the score and MACE outcomes (14:00) * Review of teaching points (17:58) For full transcript and show notes: https://www.coreimpodcast.com/2019/02/27/acute-coronary-syndrome-acs-and-the-timi-score/ (https://www.coreimpodcast.com/2019/02/27/acute-coronary-syndrome-acs-and-the-timi-score/) Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

Transcript

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0:00.0	Movies, TV, and music have influenced more of what I think than I like to actually admit.
0:05.0	Yeah, I'm embarrassed by how much medicine I've learned from TV ads or Scrubs.
0:09.0	Sadly, I totally agree with you.
0:11.0	Don't worry guys, I take it with a grain of salts and we did go to med school.
0:15.0	But not everything they get is always correct.
0:17.0	Let's take for example the key premise of one of the classic movies of the 90s, the saint.
0:21.6	It's not a classic Steve.
0:22.8	It is and it's wonderful.
0:24.1	And so Elizabeth Shoe's character
0:25.9	has to take a medication every single day
0:28.5	because otherwise she'll die of congenital heart disease.
0:31.0	Yeah, that was not realistic.
0:32.4	What disease were they even shooting for? I have no idea. congenit. Yeah, that was not realistic.
0:32.5	What disease were they even shooting for?
0:34.2	I have no idea.
0:35.5	But, you know, it's still a pretty good movie, especially if it's a rainy day.
0:39.8	One thing that TV usually does get right, though, is heart attacks. Have you noticed how often that comes up?
0:44.4	Well it's very dramatic and symbolic so I guess I get it. And to my credit sometimes their
0:49.6	recreations are spot on. You're right on. They recreate heart attacks really well. Yeah, case and point. I read that in the movie Vice the actor Christian Bale
0:57.4	actually suggested to his writer director Adam McKay that nausea and epigastric pain can be
1:02.0	symptoms of a heart attack.
1:03.0	So they went with that on film.
	...

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