Evaluation of Chest Pain in the Emergency Department
1994; American College of Physicians; Volume: 121; Issue: 12 Linguagem: Inglês
10.7326/0003-4819-121-12-199412150-00013
ISSN1539-3704
AutoresSanjiv Kaul, Robert D. Abbott,
Tópico(s)Cardiac Imaging and Diagnostics
ResumoEditorials15 December 1994Evaluation of Chest Pain in the Emergency DepartmentSanjiv Kaul, MD and Robert D. Abbott, PhDSanjiv Kaul, MDUniversity of Virginia School of Medicine; Charlottesville, VA 22908Search for more papers by this author and Robert D. Abbott, PhDUniversity of Virginia School of Medicine; Charlottesville, VA 22908Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-121-12-199412150-00013 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Chest pain is one of the most frequent symptoms for which patients are evaluated in an emergency department. Unless the cause of chest discomfort is clearly noncardiac, an evaluation to rule out acute myocardial infarction is usually initiated. Although the quality of chest pain can sometimes be helpful in decision making, it is clear that atypical chest pain does not exclude myocardial infarction [1-4]. Assessment of risk factors for coronary artery disease is also often unhelpful. Except for an occasional young patient with no risk factors in whom the probability of acute myocardial infarction is low, most patients with myocardial ...References1. Lee TH, Cook EF, Weisberg M, Sargent RK, Wilson C, Goldman L. Acute chest pain in the emergency room. Identification and examination of low-risk patients. Arch Intern Med. 1985; 145:65-9. Google Scholar2. Lee TH, Rouan GW, Weisberg MC, Brand DA, Acampora D, Stasiulewicz C, et al. Clinical characteristics and natural history of patients with acute myocardial infarction sent home from the emergency room. Am J Cardiol. 1987; 60:219-24. Google Scholar3. Sabia P, Afrookteh A, Touchstone DA, Keller MW, Esquivel L, Kaul S. 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Infarct size estimation from serial CK MB determinations: peak activity and predictability. Br Heart J. 1983; 49:373-80. Google Scholar9. Lee TH, Rouan GW, Weisberg MC, Brand DA, Cook EF, Acampora D, et al. Sensitivity of routine clinical criteria for diagnosing myocardial infarction within 24 hours of hospitalization. Ann Intern Med. 1987; 106:181-6. Google Scholar10. Goldman L, Weinberg M, Weisberg M, Olshen R, Cook EF, Sargent RK, et al. A computer-derived protocol to aid in the diagnosis of emergency room patients with chest pain. N Engl J Med. 1982; 307:588-96. Google Scholar11. Rogers JT. Risk Management in Emergency Medicine. Dallas, Texas: American College of Emergency Physicians; 1985:1-36. Google Scholar12. Sabia P, Abbott RD, Afrookteh A, Keller MW, Touchstone DA, Kaul S. The importance of two-dimensional echocardiographic assessment of left ventricular systolic function in patients presenting to the emergency room with cardiac-related symptoms. 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Emergency department diagnosis of acute myocardial infarction and ischemia: a cost analysis (Abstract). Ann Emerg Med. 1993; 22:941. Google Scholar Author, Article, and Disclosure InformationAuthors: Sanjiv Kaul, MD; Robert D. Abbott, PhDAffiliations: University of Virginia School of Medicine; Charlottesville, VA 22908Acknowledgments: The authors thank Ian J. Sarembock, MD, and George A. Beller, MD, for a critical review of this editorial.Grant Support: In part by a grant (R01-HL48890) from the National Institutes of Health, Bethesda, Maryland (Dr. Kaul). Dr. Kaul is an established investigator of the American Heart Association, Dallas, Texas. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byChest Pain Relief by Nitroglycerin Does Not Predict Active Coronary Artery DiseaseCharles A. Henrikson, MD, MPH, Eric E. Howell, MD, David E. Bush, MD, J. Shawn Miles, MD, Glenn R. Meininger, MD, Tracy Friedlander, Andrew C. Bushnell, MD, and Nisha Chandra-Strobos, MDDolores tor?cicosCost-effective evaluation of chest pain syndromesClinical Use of Ischemic Markers and Echocardiography in the Emergency DepartmentCost Effective Evaluation of Chest PainAtypical Chest Pain: A Typical Humpty Dumpty TermClinical utility of troponin T levels and echocardiography in the emergency departmentCardiologists in casualty? 15 December 1994Volume 121, Issue 12Page: 976-978KeywordsAcute myocardial infarctionDecision makingEchocardiographyElectrocardiographyEmergency departmentEnzymesInfarctionIschemiaMedical risk factorsMyocardial infarction ePublished: 15 August 2000 Issue Published: 15 December 1994 Copyright & PermissionsCopyright © 1994 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
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