IBCC Episode 2 - Ischemic Evaluation in the Non-Cardiac Patient

The podcast addresses the evaluation of ischemia in non-cardiac ICU patients, emphasizing a strategic approach to troponin testing. It argues against reflexive troponin orders, highlighting the risk of false positives and unnecessary interventions. Initial evaluation should include EKG and echocardiogram. The discussion distinguishes between Type 1 MI (plaque rupture) and Type 2 MI (demand-related), advocating different treatment strategies. Type 1 MIs may warrant aspirin, antiplatelet agents, or heparin, while Type 2 MIs primarily require addressing the underlying physiological stress. The hosts caution against the indiscriminate use of heparin, suggesting it is beneficial only when the patient is likely to undergo intervention within 48 hours. They also suggest that Fondoparanox may be preferable to heparin in some patients.