Is It Really A Heart Attack? NON STEMI VS NON SCHESTEMI

Today the house staff were perplexed when a female patient with a low level troponin elevation and with a terrible story for unstable angina  had a normal coronary angiogram. Why would a patient with the diagnosis of a non ST elevation MI have normal coronary arteries they asked? The answer is a troponin elevation is sensitive but not specific and does not equal MI without 12 lead ECG changes or segmental wall motion abnormalities (2D Echo). Low level troponin elevation without ECG changes is a NON SCHESTEMI. So this day forward a poor story for unstable angina without ECG changes or wall motion abnormalities and with a normal coronary angiogram is a NON SCHESTEMI (Should of CHecked the EcgSTEMI).

Milford Sound Queenstown

                The most beautiful glacial lake in the world in the Southern Alps of New Zealand

The Tui, song bird of New Zealand

                          The Tui with it's distinctive white, double, throat tuft of curled feathers

New Zealand in World Cup Finals!

Grant Elliot down to the last two balls hits a 6 to raise the roof in Eden Park! Black Caps reach World Cup Cricket Final!!!!!

Cricket World Cup Fever hits New Zealand!

We went to our first cricket match since coming to New Zealand on Saturday March 21st and it was a cracker! The Black Caps defeated the West Indies in Wellington. The match started very slowly with their captain and best batsman Brendon McCullum going out early. Then Matin Guptill set a World Cup record scoring 237 and energizing the 35,000 Kiwi's. Everyone was on their feet clapping and chanting Guptill, Guptill! The crowd went wild when he hit a 6 out of the stadium and onto the roof.

Bonny and I never thought cricket could be so exciting.

Now it's off to Eden Park in Auckland were every television in New Zealand will be tuned in to watch the Black Caps defeat South Africa on Tuesday March 23rd in the Cricket World Cup semi- finals. Kia Ora from the land of the long white cloud!

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ADVENTURE DOWN UNDER

My son Christian and his girlfriend Brooke decided to come back with us after Christmas for a adventure down under. We started in Queenstown with a champagne lunch on a mountain lake.

                                                   Followed by a snowball fight on a glacier.

                                              Then it was Skydiving over lake Wanaka.

MERRY CHRISTMAS FROM PONTE VEDRA BEACH FLORIDA

                                                          THE STOWERS FAMILY