Emergency cardiac stress testing in the evaluation of emergency department patients with atypical chest pain

✍ Scribed by John R Kerns; Ted F haub; Phil B ontanarosa

• Publisher: Elsevier Science
• Year: 1993
• Tongue: English
• Weight: 508 KB
• Volume: 22
• Category: Article
• ISSN: 1097-6760
• DOI: 10.1016/s0196-0644(05)80793-0

✦ Synopsis

Study objectives:

To determine the feasibility, safety, and reliability of emergency cardiac treadmill exercise stress testing (ctest) in the evaluation of emergency department patients with atypical chest pain.

Design:

Thirty-two patients with atypical chest pain, normal ecgs, and risk factor stratification having low-probability of coronary artery disease were evaluated prospectively using outpatient, emergency ctest. study patients were compared with a retrospectively selected sample of admitted patients diagnosed with atypical chest pain who met the study criteria and were evaluated with ctest as inpatients. all patients had follow-up at three and six months after evaluation.

Setting:

University-affiliated community teaching hospital with 65,000 annual ed visits.

Results:

All patients had normal ctest. no patient had evidence of coronary artery disease, myocardial infarction, or sudden death during the follow-up period. the average length of stay was 5.5 hours for emergency ctest patients versus two days for inpatients. the average patient charge was $467 for ed evaluation with emergency ctest versus $2,340 for inpatient evaluation.

Conclusion:

Emergency ctest is a safe, efficient, cost-effective, and practical method of evaluating selected ed patients with chest pain. it is a useful aid for clinical decision making and may help to prevent unnecessary hospital admissions.