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Nuclear cardiology in the evaluation of acute chest pain in the emergency department
- Source :
- Echocardiography (Mount Kisco, N.Y.). 17(6 Pt 1)
- Publication Year :
- 2000
-
Abstract
- Only a minority of patients presenting to the emergency department (ED) with acute chest pain will eventually be diagnosed with an acute coronary syndrome. The majority will have an electrocardiogram that is normal or nondiagnostic for acute myocardial ischemia or infarction. Typically, these patients are admitted to exclude myocardial infarction despite a very low incidence of coronary artery disease. However, missed myocardial infarctions in patients who are inadvertently sent home from the ED have significant adverse outcomes and associated legal consequences. This leads to a liberal policy to admit patients with chest pain, presenting a substantial burden in terms of cost and resources. Many centers have developed chest pain centers, using a wide range of diagnostic modalities to deal with this dilemma. We discuss the methods currently available to exclude myocardial ischemia and infarction in the ED, focusing on the use of myocardial perfusion imaging as both an adjunct and an alternative to routine testing. We review the available literature centering on the ED evaluation of acute chest pain and then propose an algorithm for the practical use of nuclear cardiology in this setting.
- Subjects :
- Adult
Diagnostic Imaging
Male
medicine.medical_specialty
Acute coronary syndrome
Chest Pain
Cardiology
Myocardial Infarction
Infarction
Chest pain
Sensitivity and Specificity
Coronary artery disease
Myocardial perfusion imaging
Electrocardiography
Internal medicine
medicine
Humans
Radiology, Nuclear Medicine and imaging
cardiovascular diseases
Myocardial infarction
Intensive care medicine
Aged
Tomography, Emission-Computed, Single-Photon
medicine.diagnostic_test
business.industry
Electrocardiography in myocardial infarction
Emergency department
Middle Aged
medicine.disease
Prognosis
Troponin
Connecticut
Echocardiography
Acute Disease
Female
medicine.symptom
Cardiology and Cardiovascular Medicine
business
Emergency Service, Hospital
Biomarkers
Subjects
Details
- ISSN :
- 07422822
- Volume :
- 17
- Issue :
- 6 Pt 1
- Database :
- OpenAIRE
- Journal :
- Echocardiography (Mount Kisco, N.Y.)
- Accession number :
- edsair.doi.dedup.....204aa6ff2e77b85fb8f60fec6e0bca3d