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beginning with dr. Corey slovis most everybody in emergency medicine knows dr. slovis and has learned from dr. slovis in some way Corey is professor of emergency medicine and chairman of emergency medicine at Vanderbilt and hes going to kick things off with acute coronary syndrome so as Cory likes to say giddyup right thank you very much amo certainly at least the legend in my own mind so I want to talk about our bread and butter and that is essential actions in diagnosing and treating the chest pain patient who often has or sometimes doesnt have a CS first concept I want to stress is that if we dont recognize a CS and mi early on mortality doubles we have got to see it quickly and I think patients are screwing with our heads and so Im not going to talk about angina Im going to say that a typical is typical and you shouldnt be surprised by it patients often present with symptoms that are inconsistent or sort of dont look like but could be ischemic heart disease and this article