A Critical Pathway for Patients With Acute Chest Pain and Low Risk for Short-Term Adverse Cardiac Events: Role of Outpatient Stress Testing

Annals of Emergency Medicine

Volumn 47, Issue 5, 2006, Pages

  Meyer, Mary C ^a   Mooney, Robert P ^a   Sekera, Anna K ^a  

^a KAISER PERMANENTE MEDICAL CENTER   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ACUTE DISEASE; ADULT; AGED; AGED, 80 AND OVER; AMBULATORY CARE; CALIFORNIA; CHEST PAIN; CRITICAL PATHWAYS; DIAGNOSIS, DIFFERENTIAL; EMERGENCY MEDICINE; EVIDENCE-BASED MEDICINE; EXERCISE TEST; FOLLOW-UP STUDIES; HEART DISEASES; HUMANS; MIDDLE AGED; MYOCARDIAL INFARCTION; OUTCOME AND PROCESS ASSESSMENT (HEALTH CARE); REFERRAL AND CONSULTATION; RISK ASSESSMENT;

EID: 33646042546     PISSN: 01960644     EISSN: None     Source Type: Journal    
DOI: 10.1016/j.annemergmed.2005.10.010     Document Type: Article

References (36)

1. Selker H.P., Beshansky J.R., Griffith J.L., et al. Use of the acute cardiac ischemia time-insensitive predictive instrument (ACU-TIPI) to assist with triage of patients with chest pain or other symptoms suggestive of cardiac ischemia. Ann Intern Med. 129 (1998) 845-855
2. Pope J.H., Aufderheide T.P., Ruthazer R., et al. Missed diagnoses of acute cardiac ischemia in the emergency department. N Engl J Med. 342 (2000) 1163-1170
3. McCarthy B.D. Missed diagnoses of acute myocardial infarction in the emergency department. results from a multicenter study. Ann Emerg Med. 22 (1993) 579-582
4. Lee T.H., Rouan G.W., Weisberg M.C., et al. Clinical characteristics and natural history of patients with acute myocardial infarction sent home from the emergency room. Am J Cardiol. 60 (1987) 219-224
5. Chandra A., Rudraiah L., and Zalenski R.J. Stress testing for risk stratification of patients with low to moderate probability of acute cardiac ischemia. Emerg Med Clin North Am. 19 (2001) 87-103
6. Fleischmann K.E., Goldman L., Johnson P.A., et al. Critical pathways for patients with acute chest pain at low risk. J Thromb Thrombolysis 13 (2002) 89-96
7. Goldman L., Cook E.F., Brand D.A., et al. A computer protocol to predict myocardial infarction in emergency department patients with chest pain. N Engl J Med. 318 (1988) 797-803
8. Selker H.P., Griffith J.L., and D'Agostino R.B. A tool for judging coronary care unit admission appropriateness valid for both real-time and retrospective use: a time-insensitive predictive instrument (TIPI) for acute cardiac ischemia: a multicenter study. [published correction appears in Med Care. 1992;30:188]. Med Care 29 (1991) 610-627
9. Nichol G., Walls R., Goldman L., et al. A critical pathway for management of patients with acute chest pain who are at low risk for myocardial ischemia. recommendations and potential impact. Ann Intern Med. 127 (1997) 996-1005
10. Lee T.H., Rouan G.W., Weisberg M.C., et al. Clinical characteristics and natural history of patients with acute myocardial infarction sent home from the emergency room. Am J Cardiol. 60 (1987) 219-224
11. Lee T.H., Cook E.F., Weisberg M., et al. Acute chest pain in the emergency room. identification and examination of low-risk patients. Arch Intern Med. 145 (1985) 56-59
12. Braunwald E., Antman E.M., Beasley J.W., et al. ACC/AHA 2002 guideline update for the management of patients with unstable angina and non-ST-segment elevation myocardial infarction: summary article: a report of the American College of Cardiology/American Heart Association task force on practice guidelines (Committee on the Management of Patients with Unstable Angina). J Am Coll Cardiol. 40 (2002) 2073-2078
13. Reilly B.M., Evans A.T., Schaider J.J., et al. Impact of a clinical decision rule on hospital triage of patients with suspected acute cardiac ischemia in the emergency department. JAMA 288 (2002) 342-350
14. Goldman L., Cook E.F., Johnson P.A., et al. Prediction of the need for intensive care in patients who come to emergency departments with acute chest pain. N Engl J Med. 334 (1996) 1498-1504
15. US Department of Health and Human Services, National Heart, Lung and Blood Institute. Unstable angina: diagnosis and management [National Library of Medicine Web site] Available at: http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=hstat6.chapter.21322. Accessed September 23, 2004
16. Braunwald E., Antman E.M., Beasley J.W., et al. ACC/AHA guidelines for the management of patients with unstable angina and non-ST-segment elevation myocardial infarction: executive summary and recommendations: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on the Management of Patients with Unstable Angina). Circulation 102 (2000) 1193-1209
17. The Joint International Society and Federation of Cardiology/World Health Organization Taskforce. Nomenclature and criteria for diagnosis of ischemic heart disease. report of the Joint International Society and Federation of Cardiology/World Health Organization Task Force on Standardization of Clinical Nomenclature. Circulation 59 (1979) 607-609
18. The Joint European Society of Cardiology/American College of Cardiology Committee. Myocardial infarction redefined. a consensus document of the Joint European Society of Cardiology/American College of Cardiology Committee of the Redefinition of Myocardial Infarction. Euro Heart J. 21 (2000) 1502-1513
19. Kirk J.D., Diercks D.B., Turnipseed S.D., et al. Evaluation of chest pain suspicious for acute coronary syndrome. use of an accelerated diagnostic protocol in a chest pain evaluation unit. Am J Cardiol. 85 (2000) 40B-48B
20. Lateef F., Storrow A.B., Malone K., et al. Comparison of a 6-hour and 9-hour protocol for evaluation of moderate-to-low risk chest pain patients in an emergency department diagnostic unit. Singapore Med J. 42 (2001) 52-56
21. Graff L., Zun L.S., Leikin J., et al. Emergency department observation beds improve patient care. Society for Academic Emergency Medicine debate. Ann Emerg Med. 21 (1992) 967-975
22. Gibler W.B., Runyon J.P., Levy R.C., et al. A rapid diagnostic and treatment center for patients with chest pain in the emergency department. Ann Emerg Med. 25 (1995) 1-8
23. Farkouh M.E., Smars P.A., Reeder G.S., et al. A clinical trial of a chest-pain observation unit for patients with unstable angina. Chest Pain Evaluation in the Emergency Room (CHEER) Investigators. N Engl J Med. 339 (1998) 1882-1888
24. Tatum J.L., Jesse R.L., Kontos M.C., et al. Comprehensive strategy for the evaluation and triage of the chest pain patient. Ann Emerg Med. 29 (1997) 116-125
25. Zalenski R.J., McCarren M., Roberts R., et al. An evaluation of a chest pain diagnostic protocol to exclude acute cardiac ischemia in the emergency department. Arch Intern Med. 157 (1997) 1085-1091
26. Lai C., Noeller T.P., Schmidt K., et al. Short-term risk after initial observation for chest pain. J Emerg Med. 25 (2003) 357-362
27. Pearson S.D., Goldman L., Garcia T.B., et al. Physician response to a prediction rule for the triage of emergency department patients with chest pain. J Gen Intern Med. 9 (1994) 241-247
28. Katz D.A., Griffith J.L., Beshansky J.R., et al. The use of empirical clinical data in the evaluation of practice guidelines for unstable angina. JAMA 276 (1996) 1568-1574
29. Hedges J.R., and Kobernick M.S. Detection of myocardial ischemia/infarction in the emergency department patient with chest discomfort. Emerg Med Clin North Am. 6 (1988) 317-340
30. Kobernick M.S. Management of chest pain patients. J Emerg Med. 25 (2003) 453
31. Zalenski R.J., McCarren M., Roberts R., et al. An evaluation of a chest pain diagnostic protocol to exclude acute cardiac ischemia in the emergency department. Arch Intern Med. 157 (1997) 1085-1091
32. Pratt C.M., Francis M.J., Divine G.W., et al. Exercise testing in women with chest pain. are there additional exercise characteristics that predict true positive test results?. Chest 95 (1989) 139-144
33. Amsterdam E.A., Kirk J.D., Diercks D.B., et al. Immediate exercise testing to evaluate low-risk patients presenting to the emergency department with chest pain. J Am Coll Cardiol. 40 (2002) 251-256
34. Polanczyk C.A., Johnson R.A., Hartley L.H., et al. Clinical correlates and prognostic significance of early negative exercise tolerance test in patients with acute chest pain seen in the hospital emergency department. Am J Cardiol. 81 (1998) 288-292
35. Diercks D.B., Gibler W.B., Liu T., et al. Identification of patients at risk by graded exercise testing in an emergency department chest pain center. Am J Cardiol. 86 (2000) 289-292
36. Gaspoz J.M., Lee T.H., Weinstein M.C., et al. Cost-effectiveness of a new short-stay unit to "rule-out" acute myocardial infarction in low risk patients. J Am Coll Cardiol. 24 (1994) 1249-1259