Evaluation of patients with chest pain and nondiagnostic ECG using thallium-201 myocardial planar imaging and technetium-99m first-pass radionuclide angiography in the emergency department
✍ Scribed by Philip L Henneman; Ismael G Mena; Robert J Rothstein; Karen B Garrett; Arnulfo S Pleyto; William J French
- Publisher
- Elsevier Science
- Year
- 1992
- Tongue
- English
- Weight
- 526 KB
- Volume
- 21
- Category
- Article
- ISSN
- 1097-6760
No coin nor oath required. For personal study only.
✦ Synopsis
Study objective:
The purpose of this study was to determine if thallium-201 myocardial planar imaging and technetium-99m first-pass radienuclide angiography, performed in the emergency department, could predict which patients with acute chest pain and nondiagnostic ECGs were more likely to have an acute myocardial infarction (AMI).
Design: Retrospective analysis.
Setting: Urban, county ED.
Type of participants: Convenience sample of 47 patients with acute chest pain suggestive of myocardial ischemia and nondiagnostic ECG.
Interventions: Thallium-201 myocardial imaging and technetium-99m first-pass radionuclide angiography in the ED.
Measurements and main results: Four patients had an AMI (ie, CK-MB _> 6% total CK). The combined scans had a sensitivity of 75%, (95% confidence interval [Oil,, a specificity of 42% (95% CI, 27-58%), an accuracy of 45% (95% CI, 19-99%), a positive predictive value of 11% (95% CI, 2-29%), and a negative predictive value of 95% (95% Cl, 75-100%)in predicting AMI.
Conclusion: Thallium-201 myocardial planar imaging and technetium-99m first-pass radionuclide angiography performed in the ED do not appear to be useful in determining which patients with acute chest pain and nondiagnostic ECG are likely to have an AMI.