The Canadian journal of cardiology
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Comparative Study
Clinical risk scoring beyond initial troponin values: results from a large, prospective, unselected acute chest pain population.
Risk stratifying the diverse group of patients who present to hospital with chest discomfort remains challenging. Current clinical risk models, typically derived from selected populations, are limited by their relative complexity and the absence of a well-defined role of troponin. ⋯ Significant 30-day events occurred in patients with elevated risk scores, despite negative initial troponin measurements, emphasizing the importance of clinical risk stratification. This simple clinical risk score, in conjunction with a single troponin I measurement, facilitates triage of patients who present to hospital with chest discomfort.
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Angioedema is a rare but potentially life-threatening adverse effect of angiotensin-converting enzyme inhibitors. A patient who presented with facial angioedema four months after initiating antihypertensive treatment with enalapril is described. Angioedema due to angiotensin-converting enzyme inhibitors usually appears during the first weeks of treatment. Late-onset angioedema is often unrecognized.