Talk:Myocardial infarction/GA1

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Reviewer: Jclemens (talk · contribs) 05:20, 9 March 2017 (UTC)[reply]

Rate	Attribute	Review Comment
1. Well-written:
	1a. the prose is clear, concise, and understandable to an appropriately broad audience; spelling and grammar are correct.	This is actually pretty good, for how disjointed the flow of topics and thought is.
	1b. it complies with the Manual of Style guidelines for lead sections, layout, words to watch, fiction, and list incorporation.	No issues noted
2. Verifiable with no original research:
	2a. it contains a list of all references (sources of information), presented in accordance with the layout style guideline.	Looks fine
	2b. reliable sources are cited inline. All content that could reasonably be challenged, except for plot summaries and that which summarizes cited content elsewhere in the article, must be cited no later than the end of the paragraph (or line if the content is not in prose).	Some are clearly outdated and need updating, as commented below.
	2c. it contains no original research.	There are some citation needed (CN) tags, but overall this seems not to be that much of a problem. If anything, it's such a big topic that I'm more concerned about DUE weight.
	2d. it contains no copyright violations or plagiarism.	Nothing found with Earwig's tool.
3. Broad in its coverage:
	3a. it addresses the main aspects of the topic.	Yes, broad. Not always well-focused, but broad...
	3b. it stays focused on the topic without going into unnecessary detail (see summary style).	There's too much detail on some things, but more frustratingly, there's quite a bit of inconsistency between subtopics.
	4. Neutral: it represents viewpoints fairly and without editorial bias, giving due weight to each.	I've noted a few things where the level of focus on one area seems like potential advocacy. Nothing blatant, and I expect this will be ironed out in the process of review/revision.
	5. Stable: it does not change significantly from day to day because of an ongoing edit war or content dispute.	Actively being edited, likely in response to the nom, but without any indications of edit warring.
6. Illustrated, if possible, by media such as images, video, or audio:
	6a. media are tagged with their copyright statuses, and valid non-free use rationales are provided for non-free content.	All OK, no fair use.
	6b. media are relevant to the topic, and have suitable captions.	Good mix of diagrams and photographs.
	7. Overall assessment.	Passing per improvements. This was a monumental undertaking, but one I hope benefits our readers for some time to come!

Jclemens' Good Article Review expectations for Vital Articles.

• This is a vital article. As such, it requires an appropriate amount of scrutiny, because being wrong is just that much worse, so being right is just that much more important.
• This is a collaborative process. I offer suggestions, which editors are free to implement, ignore, reject, or propose counter-suggestions. If there's simply no meeting of the minds, there will be no GA pass from me, but please feel free to tell me to take a flying leap if I propose something stupid or counterproductive.
• I do not quick fail vital article GA reviews. In general, even if there is no clear path to meet all the GA criteria, working with conscientious editors is almost always going to improve the article and benefit our readers--just not to the extent all of us had hoped.
• This is not a quick process. Estimate a month, depending on my availability and the responsiveness of the nominator and other editors collaborating on the process.
• I am not a content expert. I generally have a reasonable background in the topic under consideration, often at the college undergraduate/survey level, or else I wouldn't have volunteered to review it. Thus, I depend on the content experts to help focus the article appropriately.
• The more the merrier. While many unimportant GA articles can be adequately reviewed by a single nominator and a single reviewer, Vital Article GA's can use more eyes, based on their increased importance. I always welcome other editors to jump in with suggestions and constructive criticisms.

Thank you, Jclemens. I look forward to helping Winged Blades of Godric get this article to good article status and welcome further reviews. If you could reset your month clock to today I would be grateful as on quick glance I can see this article may have a number of issues you wish to raise. Seeing as I've just taken this up, I will spend a few days getting some up to date reviews and sources in preparation whilst I respond to your comments. Looking forward to working with you both :), --Tom (LT) (talk) 05:58, 8 April 2017 (UTC)[reply]

Ozzie10aaaa

this article meets [1]MEDMOS, however fails [2]MEDRS due to the high number of uncited text (unless corrected)have not checked for reviews within 5 years or soWikipedia:Identifying reliable sources (medicine)#Basic advice--Ozzie10aaaa (talk) 13:17, 9 March 2017 (UTC)[reply]

I expect to complete the initial read-through within about 30 hours: tomorrow is a day off for me. Jclemens (talk) 17:31, 9 March 2017 (UTC)[reply]

So, I've gotten much more delayed on this than I had anticipated. My apologies to anyone waiting for me. Jclemens (talk) 05:28, 23 March 2017 (UTC)[reply]

No worries. --Tom (LT) (talk) 05:58, 8 April 2017 (UTC)[reply]

@Jclemens goodness, this was a larger endeavor than I expected. I have marked some issues as "Addressed" so I can help focus on what's outstanding, please remove things from the list if you disagree, or add things if you think they are addressed so I can keep working on the article. --Tom (LT) (talk) 03:52, 7 May 2017 (UTC)[reply]

Yeah, we may be working on this for a while. I'll see what I can get to, maybe Monday. Jclemens (talk) 04:26, 7 May 2017 (UTC)[reply]

Slowly getting there... thank you for your patience... --Tom (LT) (talk) 23:56, 24 May 2017 (UTC)[reply]

@Jclemens OK, I am hanging my hat up for a while. Have worked through almost every aspect of the article... I expect there are a number of areas that need copyediting. Thanks for waiting. Please consider me having responded to your first tranche of comments. --Tom (LT) (talk) 11:21, 6 June 2017 (UTC)[reply]

Gotcha, will continue review from here. BTW, Tom (LT), did you just change your username to match your sig? Jclemens (talk) 16:22, 6 June 2017 (UTC)[reply]

• Can we get an update on the diet recommendations? 'five portions' etc. seem oddly specific and out of context.
•  Question: these do indeed reflect reliable sources. What changes would you suggest? --Tom (LT) (talk) 10:48, 6 June 2017 (UTC)[reply]

• TIMI scores somewhat lack context. How does their use relate to the previous paragraph?
  •  Doing... the use of TIMI is currently in discussion, see the talk page. --Tom (LT) (talk) 00:45, 3 June 2017 (UTC)[reply]

• Obviously, this needs a refresh and update. I get that 2016 numbers won't be available for a while, but surely we can do better than 2008. I'm thinking 2012-14 should be available somewhere. Jclemens (talk) 02:42, 1 May 2017 (UTC)[reply]
  • @Jclemens AMI-specific numbers are oddly hard to come by. IHD, CAD, no problem - AMI, a different story. Have had a look on google scholar, medline... any ideas? --Tom (LT) (talk) 09:59, 6 June 2017 (UTC)[reply]

• Is it just me, or is this a trivia section by another name? Seriously, it should be broken up and integrated elsewhere, unless there's something else to add to it. "Heart attacks in popular culture" could have a section of how they ONLY shock Asystole on TV... Jclemens (talk) 02:48, 1 May 2017 (UTC)[reply]

Partially implemented-I am looking to add details about "Heart attacks in popular culture" soon.Winged Blades ^Godric 04:45, 1 May 2017 (UTC)[reply]

@Winged Blades of Godric how's this section going? --Tom (LT) (talk) 00:45, 3 June 2017 (UTC)[reply]

• "The mechanism of an MI often involves the complete blockage of a coronary artery caused by a rupture of an atherosclerotic plaque." Would reversing cause and effect make this sentence more clear?
  •  Done --Tom (LT) (talk) 00:29, 11 June 2017 (UTC)[reply]
• "In ST elevation MIs treatments which attempt to restore blood flow to the heart are typically recommended and include..." What about "IN STEMI, treatments to restore the heart's blood flow include..." I think the recommendation verbiage is sufficiently obvious per WP:BLUE that even mentioning it is redundant. Jclemens (talk) 22:09, 10 June 2017 (UTC)[reply]
  •  Done --Tom (LT) (talk) 00:29, 11 June 2017 (UTC)[reply]

• "It is a type of acute coronary syndrome" Would subdivision or category be better words than 'type'?
  •  Not done splitting hairs here; I think 'type' is adequate --Tom (LT) (talk) 00:29, 11 June 2017 (UTC)[reply]
• We imply that CK-MB is specific to cardiac muscle death, but skeletal muscle can also provoke its elevation, can it not? Do we want to clarify that, or would that be splitting too many hairs?
  •  Not done Splitting hairs. It is discussed in more detail below, but I think it's important to introduce the concepts here so readers have some idea what we are talking about.--Tom (LT) (talk) 00:29, 11 June 2017 (UTC)[reply]
• We reintroduce STEMI and NSTEMI here, but use Myocardial Infarction first and MI thereafter without the parenthetical (MI) after the first usage. This should be consistent, and matching whatever the MOS says to do wouldn't hurt even if it's not strictly required at the GA level. Jclemens (talk) 22:09, 10 June 2017 (UTC)[reply]
  •  Question: I will put "(MI)" next to "myocardial infaction"... other than that, am not sure what specific change you are proposing here? --Tom (LT) (talk) 00:29, 11 June 2017 (UTC)[reply]
    • No other change, that covers it. I'd just wanted the repeated acronym use standardized. Jclemens (talk) 00:59, 11 June 2017 (UTC)[reply]

• "Shortness of breath is a common, and sometimes the only symptoms, that occurs the damage to the heart limits the output of the left ventricle, wither breathlessness arising either from subsequent hypoxemia or pulmonary edema" Needs to be clarified and quite possibly broken up.
  •  Done --Tom (LT) (talk) 12:07, 13 June 2017 (UTC)[reply]
• "Atypical symptoms, such as cardiac arrest and palpitations, occur more frequently in women, the elderly, those with diabetes, in people who have just had surgery, and in critically ill patients." I'm not familiar with calling cardiac arrest an atypical symptom of MI. Is that correct? Jclemens (talk) 02:13, 12 June 2017 (UTC)[reply]
  •  Done good point. I suppose technically this is a "sign". I've reworded this sentence slightly to reflect this. --Tom (LT) (talk) 23:45, 16 June 2017 (UTC)[reply]

• All the other risk factors are either boolean (DM II), or state directionality (older age, high blood pressure). I think High total cholesterol and LOW HDL should be explicitly stated.
  •  Done clarified. --Tom (LT) (talk) 11:29, 19 June 2017 (UTC)[reply]
• "Many risk factors of MI are shared with coronary artery disease, the primary cause of myocardial infarction," If you're going to write one out (but there's already one spelled out in the first paragraph in this sentence/section) and abbreviate another, the first one should be written in full. In this case, I think either both instances abbreviated as MI or the sentence restructured to avoid the redundancy would be fine.
  •  Done --Tom (LT) (talk) 11:29, 19 June 2017 (UTC)[reply]
• "At any given age, men are more at risk than women for the development of cardiovascular disease." Doesn't that start substantially evening out after menopause? If so, we might want to note that.
  •  Not done I couldn't find a high-quality source to verify this. --Tom (LT) (talk) 11:29, 19 June 2017 (UTC)[reply]
• Might want to explicitly state who is guessing what risk factors contributed to which MIs, rather than just reeling off percentages.
  •  Done agree. I think it is simplistic to say that 36% of MIs are caused be obesity. Atherosclerosis is multifactorial and humans are multidimensional.--Tom (LT) (talk) 11:56, 22 June 2017 (UTC)[reply]
    • Note that this got reverted, so further discussion and refinement may be appropriate. Jclemens (talk) 20:12, 22 June 2017 (UTC)[reply]
• "High levels of blood cholesterol, particularly high (increased levels of) low-density lipoprotein, low (reduced levels of) high-density lipoprotein, high (increased levels of) triglycerides." This should either be expanded with more context, or rolled into the opening sentence in this section.
  •  Done --Tom (LT) (talk) 11:29, 19 June 2017 (UTC)[reply]
• "The evidence for saturated fat['s role in MI risk] is unclear"
  •  Done --Tom (LT) (talk) 11:03, 1 July 2017 (UTC)[reply]
• Do we have anything on high sugar intake contributing directly to MI?
  •  Done no reliable sources of enough weight to justify inclusion that I could find. --Tom (LT) (talk) 11:03, 1 July 2017 (UTC)[reply]
• "Family history of ischemic heart disease or MI [is a risk factor for MI], particularly if one has a male first-degree relative (father, brother) who had a myocardial infarction before age 55 years, or a female first-degree relative (mother, sister) less than age 65."
  •  Done fixed --Tom (LT) (talk) 11:56, 22 June 2017 (UTC)[reply]
• Do we really care which genes have been associated with MI, given that we're not talking about any of them at all? Might a separate article be called for? Not only does correlation not imply causality, but it seems to be hit or miss whether the linked articles even mention the risk association at all; I didn't see any that gave an odds ratio or statistical strength of association. Jclemens (talk) 04:30, 18 June 2017 (UTC)[reply]
  • Yes we do. I haven't given prominence to these, but they do merit a mention. I think genetic risk and personalised medicine will only become more important and we should mention what little we know here. --Tom (LT) (talk) 11:56, 22 June 2017 (UTC)[reply]
    • Well, if you'd like to keep 'em in, I'm fine with that but would prefer a bit more context rather than just the bare list (including some redlinks) that we had before. Jclemens (talk) 20:10, 22 June 2017 (UTC)[reply]
      •  Done clarified --Tom (LT) (talk) 10:54, 1 July 2017 (UTC)[reply]

• "Plaques can become unstable, rupture, and additionally promote the formation of a blood clot that blocks the artery; this can occur in minutes." [...] "Exposed to the pressure associated with blood flow, plaques, especially those with a thin lining, may rupture and trigger the formation of a thrombus." Can these be harmonized so the reader understands what is going on when, and why?
  • Not sure about this one. I have tried to split up the paragraphs so that one is talking in more general terms about atherosclerosis, whereas the second is talking in specific terms about clots. What do you suggest? --Tom (LT) (talk) 10:16, 19 June 2017 (UTC)[reply]
    • I guess a single note about blocking of coronary arteries, with reference within it to the multiple underlying etiologies? Would that be reasonable? Jclemens (talk) 20:06, 22 June 2017 (UTC)[reply]
• "A heart with a limited blood supply with increased oxygen demands on the heart (such as in fever, tachycardia, hyperthyroidism, anaemia and hypotension)." Verb missing.
  •  Done --Tom (LT) (talk) 10:16, 19 June 2017 (UTC)[reply]
• "These changes are seen on gross pathology and cannot be predicted by the presence of absence of Q waves on an ECG." Presence OR absence, right?
  •  Done I wish all these points were this simple to address... --Tom (LT) (talk) 10:16, 19 June 2017 (UTC)[reply]
• Isch[a]emic cascade is linked twice in the Tissue Death section.
  •  Done --Tom (LT) (talk) 10:16, 19 June 2017 (UTC)[reply]
• Nowhere does the Tissue Death section make it clear that 'infarction' is cell death. That may seem obvious to you and I, but not to all of our readers.
  •  Done Good point... except I do mention this in the lead. Clarified in the section as well. --Tom (LT) (talk) 10:16, 19 June 2017 (UTC)[reply]
• It would be nice if the tissue death section talked about the various zones, c.f. this (presumably non-free, included for example, not use in the article absent licensing [3]. Jclemens (talk) 04:17, 19 June 2017 (UTC)[reply]
  •  Done --Tom (LT) (talk) 11:58, 1 July 2017 (UTC)[reply]

• For Criteria, it's not entirely clear: You need to have biomarkers and one of the bulleted items, or all of them?
  •  Done clarified. --Tom (LT) (talk) 11:51, 22 June 2017 (UTC)[reply]
• For cardiac biomarkers, I think it would be appropriate to mention that CK-MB, etc. have been superseded, rather than that they're just discouraged. In other words, paint a bit of history into describing the current state of practice.
  • Not sure here. In my mind, these are different investigations with one being preferred for MI, and the other two being discouraged for use. It is (in my mind) not the same as saying CK has been superseded by CK-MB, or Troponin T with high-sensitivity troponin, etc.--Tom (LT) (talk) 11:51, 22 June 2017 (UTC)[reply]
• For ECGs: Are we correctly differentiating between the stickers and the printout? Between wires and leads? Also, I'd consider wikilinking the first electrocardiogram in the section, even if it means taking it out of the Criteria section, since this is the most relevant section. I'd go so far as to suggest the current Criteria wikilink to ECG be retargeted to the Electrocardiogram section, rather than being a true Wikilink.
  • Linked the first entry. Could you clarified what specfic parts of this paragraph you are concerned about? --Tom (LT) (talk) 11:51, 22 June 2017 (UTC)[reply]
• For DDx, consider adding costochondritis? While it's pretty trivial to differentiate for providers, it is still a common cause of non-cardiac chest pain.
  •  Done good point --Tom (LT) (talk) 11:51, 22 June 2017 (UTC)[reply]
• Overall, this section is much cleaner and better organized during the first go-round. I'm very happy with what I'm seeing. Jclemens (talk) 03:16, 22 June 2017 (UTC)[reply]
  • Thanks :) --Tom (LT) (talk) 11:51, 22 June 2017 (UTC)[reply]

• "Thrombolysis is not recommended in a number of situations, particularly when associated with a high risk of bleeding, past strokes or bleeds into the brain, severe hypertension, and active bleeding" Is a high risk of bleeding the first list entry, or does it describe the rest of the list? Everything except severe hypertension appears to be bleeding-related in this sentence.
  • High risk of bleeding -- on anticoagulants, coagulation disorders, thrombocytopaenia etc. Active bleeding - as stated. Past bleeds into the brain - as stated. These are different things; so one entry can't unfortunately encompass all three. --Tom (LT) (talk) 11:04, 22 June 2017 (UTC)[reply]
    • I guess my concern is that a previous hemorrhagic stroke IS a high risk for bleeding. Maybe "who are currently bleeding or have high risk for problematic bleeding such as current ABC or history of XYZ" or something like that? Jclemens (talk) 20:09, 22 June 2017 (UTC)[reply]
      •  Done wording clarified. --Tom (LT) (talk) 12:03, 1 July 2017 (UTC)[reply]
• "Therefore, oxygen is currently only recommended if oxygen levels are found to be low or if someone is in respiratory distress." Would it hurt to increase specificity and call "someone" a patient?
  • I lean towards trying not to use the word "patient" as I feel that approaches the article from a medical perspective, whereas we are lay encyclopedia. No specific guidance when I checked WP:MEDMOS. --Tom (LT) (talk) 11:04, 22 June 2017 (UTC)[reply]
    • Fair enough. Sufferer? Victim? How do we denote in-text that the person in question is the one having the MI? Jclemens (talk) 20:09, 22 June 2017 (UTC)[reply]
      • I feel this is implied. --Tom (LT) (talk) 12:00, 1 July 2017 (UTC)[reply]
• "After PCI, people are generally placed on dual antiplatelet therapy for at least a year (which is generally aspirin and clopidogrel)" 1) People could again be 'patients'--should it be? 2) I've seen differing durations of dual antiplatelet therapy based on drug-eluting vs. bare metal stents. Is that worth mentioning here?
  • Recommendation for anticoagulation for antiplatelet therapy for PCI in AMI appears to be at least one year irrespective of stent type [4].--Tom (LT) (talk) 12:50, 1 July 2017 (UTC)[reply]
• In rehab, do we really need to link driving and sexual intercourse? Seems overlinkage to me. Jclemens (talk) 03:27, 22 June 2017 (UTC)[reply]
  •  Done agree, there is no need for these to be linked. --Tom (LT) (talk) 11:04, 22 June 2017 (UTC)[reply]

• Make the time differentiation between primary and secondary prevention a bit more explicit? I understand exactly what you're saying, but could we benefit from being a tad more pedantic/explicit here?
  • I feel further exploration of the time course of primary and secondary prevention may confuse matters. Both terms are defined in the section introduction. Secondary prevention often starts within the day or two after an event. Some (eg no smoking or drinking) may be thought of as starting instantly, given that most hospitals do not allow these on site. --Tom (LT) (talk) 14:02, 2 July 2017 (UTC)[reply]
• "non drinking or drinking alcohol within the recommended limits" Not drinking any more alcohol than recommended, maybe?
  • Good point... Reworded both instances. --Tom (LT) (talk) 14:02, 2 July 2017 (UTC)[reply]
• "The dietary pattern with the greatest support" Scientific support? Reduced all cause mortality?
• "Olive oil, rapeseed oil and related products are to be used instead of saturated fat." .. recommended instead of?
  • Had to laugh at how prescriptive that sounded. Reworded. --Tom (LT) (talk) 14:02, 2 July 2017 (UTC)[reply]
• Overall, there's a lot here that relies on Ref 94, a UK government document which I have no reason to believe is any less bought and paid for by various food lobbies than the US FDA equivalents are. Do we have anything better? I fear not, but thought I'd ask.
  • Good point. I've rejigged and copyedited the paragraph to decrease the prominence of their suggestions, but included the dietary advice as a (common, worth mentioning) example of advice that is given.--Tom (LT) (talk) 14:02, 2 July 2017 (UTC)[reply]
• The statement in favor of statins for primary prevention should likely be stronger.
  • Good point. I have increased its prominence, clarified it, and improved the source used (And also corrected the secondary prevention source). --Tom (LT) (talk) 14:02, 2 July 2017 (UTC)[reply]
• The statement in favor of HRT seems too strong for what I understand of the topic. Jclemens (talk) 04:16, 23 June 2017 (UTC)[reply]
  • Agree. Removed. --Tom (LT) (talk) 14:02, 2 July 2017 (UTC)[reply]

• "... clots transmitted from the heart during PCI" Traveling?
  •  Not done the meanings are equivalent. --Tom (LT) (talk) 10:08, 24 June 2017 (UTC)[reply]
    • The meanings may be equivalent and transmission a technically correct term, but I do suggest not needlessly inflating the reading level of the article. In common U.S. usage, nothing physical is transmitted, while knowledge, radio waves, etc. can be. Jclemens (talk) 17:38, 24 June 2017 (UTC)[reply]
• "...and [is] the largest cause of in-hospital mortality" While it looks like the 'is' from the previous clause might serve double duty, it looks less awkward to repeat it here, I think. Jclemens (talk) 04:16, 23 June 2017 (UTC)[reply]
  •  Done fixed --Tom (LT) (talk) 10:08, 24 June 2017 (UTC)[reply]

• No issues. I know I've already asked for more current data once and you couldn't find any. Jclemens (talk) 06:32, 23 June 2017 (UTC)[reply]

• Gotta have something on there about shocking asystole! I kid, that would be under depictions of cardiac arrest in popular culture... No other issues, and THAT is the second read-through. Jclemens (talk) 06:32, 23 June 2017 (UTC)[reply]

• I'm going to be picking on these based on age, which I know is not the sole determinant of whether a study should be included. Feel free to disagree, and to make sure the journals in question are top tier, but I've not seen anything obviously predatory. I get that some of these are seminal references with lasting impact beyond a 5-10 year window, but I want to make sure each pre-2007 reference is scrutinized appropriately.
  • Thank you, I really appreciate this.--Tom (LT) (talk) 01:23, 11 June 2017 (UTC)[reply]
• DAVIDSONS2010B is defined twice, which looks to be just different pages of the same book.
  •  Done Fixed. --Tom (LT) (talk) 01:23, 11 June 2017 (UTC)[reply]
• "Little RA, Frayn KN, Randall PE, Stoner HB, Morton C, Yates DW, Laing GS (1986). "Plasma catecholamines in the acute phase of the response to myocardial infarction"" is 30+ years old. Please replace with something current.
  •  Done --Tom (LT) (talk) 12:06, 13 June 2017 (UTC)[reply]
• "Wilson PW, D'Agostino RB, Levy D, Belanger AM, Silbershatz H, Kannel WB (1998). "Prediction of coronary heart disease using risk factor categories"" is almost 20 years ago, please replace if possible.
  •  Done removed and updated the European Guidelines (now 2012). --Tom (LT) (talk) 01:23, 11 June 2017 (UTC)[reply]
• "Indications for fibrinolytic therapy in suspected acute myocardial infarction: collaborative overview of early mortality and major morbidity results from all randomised trials of more than 1000 patients. Fibrinolytic Therapy Trialists' (FTT) Collaborative Group.". Lancet. 343 (8899): 311–22. Mar 1994" is 20+ years old, please replace if possible.
  •  Done Replaced. --Tom (LT) (talk) 01:23, 11 June 2017 (UTC)[reply]
• "http://www.thennt.com/nnt/beta-blockers-for-heart-attack/" Needs full citation info.
  •  Done --Tom (LT) (talk) 01:23, 11 June 2017 (UTC)[reply]
• "Antman EM; Cohen M; et. al. (2000). "The TIMI risk score for unstable angina/non-ST elevation MI: A method for prognostication and therapeutic decision making."" also "David A. Morrow; et. al. (2000). "TIMI Risk Score for ST-Elevation Myocardial Infarction: A Convenient, Bedside, Clinical Score for Risk Assessment at Presentation: An Intravenous nPA for Treatment of Infarcting Myocardium Early II Trial Substudy."" 15+ years old--is there something newer?
  •  Done --Tom (LT) (talk) 12:06, 13 June 2017 (UTC)[reply]
• "Becker RC, Gore JM, Lambrew C, Weaver WD, Rubison RM, French WJ, Tiefenbrunn AJ, Bowlby LJ, Rogers WJ; Gore; Lambrew; Weaver; Rubison; French; Tiefenbrunn; Bowlby; Rogers (1996). "A composite view of cardiac rupture in the United States National Registry of Myocardial Infarction"." Anything newer?
  •  Done no newer secondary sources. Because therapies have changed in the last 21 years, I've opted to remove this statement. --Tom (LT) (talk) 00:01, 17 June 2017 (UTC)[reply]
• "Perry, K; Petrie, KJ; Ellis, CJ; Horne, R; Moss-Morris, R (July 2001). "Symptom expectations and delay in acute myocardial infarction patients."" Anything newer?
  •  Not done nothing newer I can locate. --Tom (LT) (talk) 00:01, 17 June 2017 (UTC)[reply]
• Overall, I am really happy with the prevalence of 2010-present dated citations in the ref list. Jclemens (talk) 22:25, 10 June 2017 (UTC)[reply]

@Doc James, Jclemens, do you know any editors who might be willing to do a review of the sources used on this article? I would like a separate reviewer to just focus on the sources used here... there seems to be quite a lot which are either primary sources or very old, and if they are identified I can get to work updating or removing them. --Tom (LT) (talk) 01:29, 17 April 2017 (UTC)[reply]

Anything older than 2010 should likely be updated. Was looking at getting a tool that would tag all articles that are reviews as reviews. Doc James (talk · contribs · email) 01:33, 17 April 2017 (UTC)[reply]

I don't personally know any cardiologists inclined to spend time on Wikipedia, no, but I expect either of us could find more current sources. I know I have all the usual suspects of medical databases at my disposal through my non-Wikipedia affiliations. Jclemens (talk) 01:39, 17 April 2017 (UTC)[reply]

Hi Arubaska (Winged Blades of Godric), I note that you are in school, and (as far as I can see) haven't made any major edits to this article. I expect that you are very busy and may not have the full time to address all the concerns raised here. If you and Jclemens are happy, given the importance of this article, I am happy to take on a role as a conominator to help address reviewer concerns. I'll get to responding above and, if you feel like you would like to take back the baton, please let me know :). Cheers --Tom (LT) (talk) 05:29, 8 April 2017 (UTC)[reply]

@Jclemens and LT910001:--Sorry, the last time I was pinged related to this was long back when JC started reviewing the page.For the next two or three days there wasn't any progress from him--(due to certain concerns by him) and I lost my interest.Gotcha watchlisted it!And JC even a simple ping would have attracted my attention!I am receiving the next ping today and seeing all the progress, all of a sudden!Anyway I will be improving the article w.r.t to the concerns raised by JC and if you(Tom) want to help the article in it's way to GA status, I am generously and gladly accepting it!Cheers!Winged Blades ^Godric 12:35, 8 April 2017 (UTC)[reply]

Sounds good. I'll help out as I can. --Tom (LT) (talk) 23:41, 8 April 2017 (UTC)[reply]

I hadn't had any feedback from anyone on anything here, so I admit it has been less of a priority because of that. I am willing to continue reviewing, but honestly will have limited time for the next few weeks due to non-Wikipedia concerns, so having someone else take over makes sense to me. Jclemens (talk) 16:11, 9 April 2017 (UTC)[reply]

@LT910001: Ok, I've none through more of the article, and will continue to try to slog through it--as a break from the things I should be doing, actually... Hopefully, once I get to the bottom we can start at the top again... Jclemens (talk) 06:39, 15 April 2017 (UTC)[reply]

So here I changed Coronary artery bypass surgery to coronary artery bypass surgery as the word is not at the beginning of a sentence it does not need a capital letter.

This text was trimmed "An ECG, which displays the electrical currents associated with contraction of heart muscle, produces a regular form." as it is without a reference and does not really make sense.

Why was myocardial infarction bolded in the caption? Where does the MOS support this? Doc James (talk · contribs · email) 09:02, 10 April 2017 (UTC)[reply]

How are we doing? Are we ready for any part of a re-review? Jclemens (talk) 01:11, 13 May 2017 (UTC)[reply]

Sorry, I have been unusually busy this week. I am slowly making my way through this article, adding content, fixing, simplifying and adding / replacing sources. When that's done, I'll run through and address what is remaining. You can use my little lists of 'addressed' as as a guide to what I'm working on - so far only signs & symptoms is ready for a re-review. --Tom (LT) (talk) 11:55, 13 May 2017 (UTC)[reply]

@Jclemens responded to second trache. Thanks for your patience. I have left a message on your talk page. Looking forward to your response, --Tom (LT) (talk) 14:17, 2 July 2017 (UTC)[reply]

This process appears to be ongoing. Why did Legobot change the status of the article to GA on 2 July, and should we remove that? Jytdog (talk) 17:43, 4 July 2017 (UTC)[reply]

I passed it. It's still being improved, but has met all the GA criteria for a while now. Apologies for not making this clearer; hopefully this note clears things up better than the annotation to the GATable did. Jclemens (talk) 17:51, 4 July 2017 (UTC)[reply]

Thanks for clarifying. Jytdog (talk) 18:08, 4 July 2017 (UTC)[reply]