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Ann Emerg Med. 1993 May;22(5):794-8.

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

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1
Department of Emergency Medicine, Northeastern Ohio Universities College of Medicine, Akron.

Abstract

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.

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PMID:
8470835
[Indexed for MEDLINE]
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