High-Risk Chief Complaints I: Chest Pain-The Big Three

Emergency Medicine Clinics of North America

Volumn 27, Issue 4, 2009, Pages 685-712

  Woo, Kar mun C ^a   Schneider, Jeffrey I ^a  

^a BOSTON MEDICAL CENTER   (United States)

Author keywords

Cardiac tamponade; Chest pain; Esophageal rupture; Myocardial infarction; Pulmonary embolism; Risk management; Tension pneumothorax; Thoracic aortic dissection

Indexed keywords

BETA ADRENERGIC RECEPTOR BLOCKING AGENT; CREATINE KINASE MB; D DIMER; GLYCERYL TRINITRATE; OMEPRAZOLE; PLACEBO;

ACUTE CORONARY SYNDROME; ACUTE HEART INFARCTION; AORTA DISSECTION; ATHEROSCLEROTIC PLAQUE; BLOOD CLOT LYSIS; CARDIOPULMONARY EXERCISE TEST; CLINICAL TRIAL; COMPUTED TOMOGRAPHIC ANGIOGRAPHY; CORONARY ARTERY DISEASE; DIAGNOSTIC ACCURACY; DIAGNOSTIC ERROR; ECG ABNORMALITY; ESOPHAGUS RUPTURE; GASTROESOPHAGEAL REFLUX; HEART MUSCLE ISCHEMIA; HEART TAMPONADE; HIGH RISK POPULATION; HOSPITAL DISCHARGE; HUMAN; LUNG EMBOLISM; PERICARDIAL EFFUSION; PHYSICAL EXAMINATION; PNEUMOTHORAX; PRIORITY JOURNAL; REVIEW; RISK MANAGEMENT; SENSITIVITY AND SPECIFICITY; THORAX PAIN; UNSTABLE ANGINA PECTORIS;

EID: 70450129301     PISSN: 07338627     EISSN: 07338627     Source Type: Journal    
DOI: 10.1016/j.emc.2009.07.007     Document Type: Review

References (181)

1. Klompas M. Does this patient have an acute aortic dissection?. JAMA 287 17 (2002) 2262-2272
2. Mehta R.H., and Eagle K.A. Missed diagnoses of acute coronary syndromes in the emergency room-continuing challenges. N Engl J Med 342 16 (2000) 1207-1210
3. Schor S., Behar S., Modan B., et al. Disposition of presumed coronary patients from an emergency room: a follow-up study. JAMA 236 8 (1976) 941-943
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. McCarthy B.D., Beshansky J.R., D'Agostino R.B., et al. Missed diagnoses of acute myocardial infarction in the emergency department: results from a multicenter study. Ann Emerg Med 22 (1993) 579-582
6. Pope J.H., Aufderheide T.P., Ruthazer R., et al. Missed diagnosis of acute cardiac ischemia in the emergency department. N Engl J Med 342 (2000) 1163-1170
7. Pope J.H., and Selker H.P. Acute coronary syndromes in the emergency department: diagnostic characteristics, tests, and challenges. Cardiol Clin 23 (2005) 423-451
8. Beckmann C.H. How to avoid being swept away by the rising tide of malpractice litigation. Am J Cardiol 91 (2003) 585-586
9. Kannel W.B., and Abbot R.D. Incidence and prognosis of unrecognized myocardial infarction: an update of the Framingham Study. N Engl J Med 311 (1984) 1144-1147
10. Canto J.G., Shlipak M.G., Rogers W.J., et al. Prevalence, clinical characteristics, and mortality among patients with myocardial infarction presenting without chest pain. JAMA 283 (2000) 3223-3229
11. Dorsch M.F., Lawrence R.A., Sapsford R.J., et al. Poor prognosis of patients presenting with symptomatic myocardial infarction but without chest pain. Heart 86 (2001) 494-498
12. Brieger D., Eagle K.A., Goodman S.G., et al. Acute coronary syndromes without chest pain, an underdiagnosed and undertreated high-risk group: insights from the Global Registry of Acute Coronary Events (GRACE). Chest 126 (2004) 461-469
13. Coronado B.E., Pope J.H., Griffith J.L., et al. Clinical features, triage, and outcome of patients presenting to the ED with suspected acute coronary syndromes but without pain: a multicenter study. Am J Emerg Med 22 (2004) 568-574
14. Canto J.G., Fincher C., Kiefe C.I., et al. Atypical presentations among Medicare beneficiaries with unstable angina pectoris. Am J Cardiol 90 (2002) 248-253
15. Lee H.O. Typical and atypical clinical signs and symptoms of myocardial infarction and delayed seeking of professional care among blacks. Am J Crit Care 6 1 (1997) 7-13
16. Arslanian-Engoren C., Patel A., Fang J., et al. Symptoms of men and women presenting with acute coronary syndromes. Am J Cardiol 98 (2006) 1177-1181
17. Patel H., Rosengreen A., and Ekman I. Symptoms in acute coronary syndromes: does sex make a difference?. Am Heart J 148 (2004) 27-33
18. Milner K.A., Funk M., Richards S., et al. Gender differences in symptom presentation associated with coronary heart disease. Am J Cardiol 84 (1999) 396-399
19. Kudenchuk P.J., Maynard C., Martin J.S., et al. Comparison of presentation, treatment, and outcome of acute myocardial infarction in men versus women (the Myocardial Infarction Triage and Intervention Registry). Am J Cardiol 78 (1996) 9-14
20. Johns P.A., Lee T.H., Cook F., et al. Effect of race on the presentation and management of patients with acute chest pain. Ann Intern Med 118 (1993) 593-601
21. Pezzin L.E., Keyl P.M., and Green G.B. Disparities in the emergency department evaluation of chest pain patients. Acad Emerg Med 14 (2007) 149-156
22. Egred M., Viswanathan G., and Davis G.K. Myocardial infarction in young adults. Postgrad Med J 81 (2005) 741-745
23. Chen L., Chester M., and Kaski J.C. Clinical factors and angiographic features associated with premature coronary artery disease. Chest 108 2 (1995) 364-369
24. Anonymous. Reduce legal risks of chest pain. ED Manag 10 11 (1998) 126-128
25. Walker N.J., Sites F.D., Shofer F.S., et al. Characteristics and outcomes of young adults who present to the emergency department with chest pain. Acad Emerg Med 8 7 (2001) 703-708
26. Marsan R.J., Shaver K.J., Sease K.L., et al. Evaluation of a clinical decision rule for young adult patients with chest pain. Acad Emerg Med 12 1 (2005) 26-32
27. Goodacre S., Locker T., and Campbell S. How useful are clinical features in the diagnosis of acute, undifferentiated chest pain?. Acad Emerg Med 9 3 (2002) 203-208
28. Chun A.A., and McGee S.R. Bedside diagnosis of coronary artery disease: a systematic review. Am J Med 117 (2004) 334-343
29. Swap C.J., and Nagurney J.T. Value and limitations of chest pain history in the evaluation of patients with suspected acute coronary syndromes. JAMA 294 20 (2005) 2623-2629
30. Panju A.A., Hemmelgarn B.R., Guyatt G.H., et al. The rational clinical examination: is this patient having a myocardial infarction?. JAMA 280 14 (1998) 1256-1263
31. Anderson J.L., Adams C.D., Antman E.M., et al. ACC/AHA 2007 guidelines for the management of patients with unstable angina/non-ST-segment elevation myocardial infarction: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing committee to revise the 2002 guidelines for the management of patients with unstable angina/non-ST-elevation myocardial infarction): developed in collaboration with the American College of Emergency Physicians, American College of Physicians, Society for Academic Emergency Medicine, Society for Cardiovascular Angiography and Interventions, and Society for Thoracic Surgeons. J Am Coll Cardiol 50 (2007) 652-726
32. 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) 65-69
33. Everts B., Karlson B.W., Wahrborg P., et al. Localization of pain in suspected acute myocardial infarction in relation to final diagnosis, age and sex, and site and type of infarction. Heart Lung 25 (1996) 430-437
34. Gordon T, Sorlie P, Kannel WB. Coronary heart disease, atherothrombotic brain infarction, intermittent claudication-a multivariate analysis of some factors related to their incidence: Framingham Study, 16 year follow-up. Section 27, U.S. Govt. Print. Office; 1971.
35. Jayes R.L., Beshansky J.R., D'Agostino R.B., et al. Do patients' coronary risk factor reports predict acute cardiac ischemia in the emergency department? A multicenter study. J Clin Epidemiol 45 6 (1992) 621-626
36. Antman E.M., Cohen M., Bernink P.J.L., et al. The TIMI risk score for unstable angina/non-ST elevation MI: a method for prognostication and therapeutic decision making. JAMA 284 7 (2000) 835-842
37. Shry E.A., Dacus J., Van De Graaff E., et al. Usefulness of the response to sublingual nitroglycerin as a predictor of ischemic chest pain in the emergency department. Am J Cardiol 90 11 (2002) 1264-1266
38. Henrikson C.A., Howell E.E., Bush D.E., et al. Chest pain relief by nitroglycerin does not predict active coronary artery disease. Ann Intern Med 139 (2003) 979-986
39. Diercks D.B., Boghos E., Guzman H., et al. Changes in the numeric descriptive scale for pain after sublingual nitroglycerin do not predict cardiac etiology of chest pain. Ann Emerg Med 45 (2005) 581-585
40. Servi R.J., and Skiendzielewski J.J. Relief of myocardial ischemia pain with a gastrointestinal cocktail. Am J Emerg Med 3 3 (1985) 208-209
41. Dickinson M.W. The "GI cocktail" in the evaluation of chest pain in the emergency department. J Emerg Med 14 2 (1996) 245-246
42. Chauhan A., Mullins P.A., Taylor G., et al. Cardioesophageal reflex: a mechanism for "linked angina" in patients with angiographically proven coronary artery disease. J Am Coll Cardiol 27 7 (1996) 1621-1628
43. Dobrzycki S., Baniukiewicz A., Korecki J., et al. Does gastro-esophageal reflux provoke the myocardial ischemia in patients with CAD?. Int J Cardiol 104 (2005) 67-72
44. Budzynski J., Klopocka M., Pulkowski G., et al. The effect of double dose of omeprazole on the course of angina pectoris and treadmill stress test in patients with coronary artery disease-a randomised, double-blind, placebo controlled, crossover trial. Int J Cardiol 127 (2007) 233-239
45. Smith K.S., and Papp C. Episodic, postural, and "linked angina". Br Med J 2 5317 (1962) 1425-1430
46. Fesmire F.M., Percy R.F., Bardoner J.B., et al. Usefulness of automated serial 12-lead ECG monitoring during the initial emergency department evaluation of patients with chest pain. Ann Emerg Med 31 (1998) 3-11
47. Fesmire F.M., Decker W.W., Diercks D.B., et al. Clinical policy: critical issues in the evaluation and management of adult patients with non-ST-segment elevation acute coronary syndromes-from the American College of Physicians clinical polices subcommittee. Ann Emerg Med 48 (2006) 270-301
48. Masoudi F.A., Magid D.J., Vinson D.R., et al. Implications of the failure to identify high-risk electrocardiogram findings for the quality of care of patients with acute myocardial infarction-results of the Emergency Department Quality in Myocardial Infarction (EDQMI) Study. Circulation 114 (2006) 1565-1571
49. Brady W.J., Perron A.D., and Ullman E. Errors in emergency physician interpretation of ST-segment elevation in emergency department chest pain patients. Acad Emerg Med 7 (2000) 1256-1260
50. Erling B.F., Perron A.D., and Brady W.J. Disagreement in the interpretation of electrocardiographic ST segment elevation: a source of error for emergency physicians?. Am J Emerg Med 22 (2004) 65-70
51. Balk E.M., Ioannidis J.P.A., Salem D., et al. Accuracy of biomarkers to diagnose acute cardiac ischemia in the emergency department: a meta-analysis. Ann Emerg Med 37 (2001) 478-494
52. Limkakeng A., Gibler W.B., Pollack C., et al. Combination of Goldman risk and initial cardiac troponin I for emergency department chest pain patient risk stratification. Acad Emerg Med 8 (2001) 696-702
53. Ebell M.H., Flewelling D., and Flynn C.A. A systematic review of troponin T and I for diagnosing acute myocardial infarction. J Fam Pract 49 (2000) 550-556
54. Smith S.W., Tibbles C.D., Apple F.S., et al. Outcome of low-risk patients discharged home after a normal cardiac troponin I. J Emerg Med 26 4 (2004) 401-406
55. Fesmire F.M. Delta CK-MB outperforms delta troponin I at 2 hours during the ED rule out of acute myocardial infarction. Am J Emerg Med 18 (2000) 1-8
56. Fesmire F.M., Christenson R.H., Fody E.P., et al. Delta creatinine kinase-MB outperforms myoglobin at two hours during the emergency department identification and exclusion of troponin positive non-ST-segment elevation acute coronary syndromes. Ann Emerg Med 44 (2004) 12-19
57. Pope J.H., Ruthazer R., Beshansky J.R., et al. Clinical features of emergency department patients presenting with symptoms suggestive of acute cardiac ischemia: a multicenter study. J Thromb Thrombolysis 6 (1998) 63-74
58. Braunwald E., Mark D.B., Jones R.H., et al. Unstable angina: diagnosis and management (1994), Agency for Health Care Policy and Research, Rockville (MD) Publication No. 94-06062
59. Zalenski RJ, 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 157:1085-91.
60. Polanczyk C.A., Johnson P.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
61. Mikhail M.G., Smith F.A., Gray M., et al. Cost-effectiveness of mandatory stress testing in chest pain center patients. Ann Emerg Med 29 1 (1997) 88-98
62. 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
63. Meyer M.C., Mooney R.P., and Sekera A.K. A critical pathway for patients with acute chest pain and low risk for short-term adverse cardiac events: role of outpatient stress testing. Ann Emerg Med 47 (2006) 427-435
64. Duseja R., and Feldman J.A. Missed acute cardiac ischemic in the ED: limitations of diagnostic testing. Am J Emerg Med 22 3 (2004) 219-225
65. Smith S.W., Jackson E.A., Bart B.A., et al. Incidence of myocardial infarction in emergency department chest pain patients with a recent negative stress imaging test. [abstract]. Acad Emerg Med 12 5 Suppl 1 (2005) 51
66. Raff G.L., Gallagher M.J., O'Neill W.W., et al. Diagnostic accuracy of noninvasive coronary angiography using 64-slice spiral computed tomography. J Am Coll Cardiol 46 (2005) 552-557
67. Hoffman U., Nagurney J.T., Moselewski F., et al. Coronary multidetector computed tomography in the assessment of patients with acute chest pain. Circulation 114 (2006) 2251-2260
68. Rubinshteim R., Halon D.A., Gaspar T., et al. Usefulness of 64-slice cardiac computed tomographic angiography for diagnosing acute coronary syndromes and predicting clinical outcome in emergency department patients with chest pain of uncertain origin. Circulation 115 (2007) 1762-1768
69. Meijboom W.B., Mollet N.R., Mieghem C.A.V., et al. 64-slice CT coronary angiography in patients with non-ST elevation acute coronary syndromes. Heart 93 (2007) 1386-1392
70. Gallager M.J., Ross M.A., Raff G.L., et al. The diagnostic accuracy of 64-slice computed tomography coronary angiography compared with stress nuclear imaging in emergency department low-risk chest pain patients. Ann Emerg Med 49 (2007) 125-136
71. Goldstein J.A., Gallagher M.J., O'Neill W.W., et al. A randomized controlled trial of multi-slice coronary computed tomography for evaluation of acute chest pain. J Am Coll Cardiol 49 (2007) 863-871
72. Hollander J.E., Chang A.M., Shofer F.S., et al. Coronary computed tomographic angiography for rapid discharge of low-risk patients with potential acute coronary syndromes. Ann Emerg Med 53 3 (2009) 295-304
73. Barnett K., and Feldman J.A. Noninvasive imaging techniques to aid in the triage of patients with suspected acute coronary syndrome: a review. Emerg Med Clin North Am 23 (2005) 977-998
74. Newman D.H. Computed tomographic angiography for low risk chest pain: seeking passage. Ann Emerg Med 53 3 (2009) 305-308
75. Braunwald E., Brown J., Brown L., et al. Unstable angina: diagnosis and management. Clinical practice guideline number 10 (1994), Agency for Health Care Policy and Research, US Public Health Service, US Department of Health and Human Services, Rockville (MD)
76. Hollander J.E. Risk stratification of emergency department patients with chest pain: the need for standardized reporting guidelines. Ann Emerg Med 43 1 (2004) 68-70
77. Katz D.A., Aufderheid T.P., Bogner M., et al. The impact of unstable angina guidelines in the triage of emergency department patients with possible acute coronary syndrome. Med Decis Making 26 (2006) 606-616
78. 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. Med Care 29 7 (1991) 610-627
79. Selker H.P., Beshansky J.R., Griffith J.L., et al. Use of the Acute Cardiac Ischemia Time-Insensitive Predictive Instrument (ACI-TIPI) to assist with triage of patients with chest pain or other symptoms suggestive of acute cardiac ischemia: a multicenter, controlled clinical trial. Ann Intern Med 129 11 (1998) 845-855
80. Lau J., Ioannidis J., Balk E., et al. Evaluation of technologies for identifying acute cardiac ischemia in emergency departments. Evidence Report/Technology Assessment Number 26. (Prepared by The New England Medical Center Evidence-based Practice Center under Contract No. 290-97-0019) AHRQ Publication No. 01-E006 (May 2001), Agency for Healthcare Research and Quality, Rockville (MD)
81. Pollack C.V., Sites F.D., Shofer F.S., et al. Application of the TIMI risk score for unstable angina and non-ST elevation acute coronary syndrome to an unselected emergency department chest pain population. Acad Emerg Med 13 1 (2006) 13-18
82. Chase M., Robey J.L., Zogby K.E., et al. Prospective validation of the Thrombolysis in Myocardial Infarction Risk score in the emergency department chest pain population. Ann Emerg Med 48 3 (2006) 252-259
83. Antman E.M., McCabe C.H., Gurfinkel E.P., et al. Enoxaparin prevents death and cardiac ischemic events in unstable angina/non-Q-wave myocardial infarction: results of the Thrombolysis in Myocardial Infarction (TIMI) 11B trial. Circulation 100 (1999) 1593-1601
84. Jaffery Z., Hudson M.P., Jacobsen G., et al. Modified thrombolysis in myocardial infarction (TIMI) risk score to risk stratify patients in the emergency department with possible acute coronary syndrome. J Thromb Thrombolysis 24 (2007) 137-144
85. Ramsay G., Podogrodzka M., McClure, et al. Risk prediction in patients presenting with suspected cardiac pain: the GRACE and TIMI risk scores. QJM 100 1 (2007) 11-18
86. Rusnak R.A., Stair T.O., Hansen K., et al. Litigation against the emergency physician: common features in cases of missed myocardial infarction. Ann Emerg Med 18 (1989) 1029-1034
87. Acute myocardial infarction study (1996), Physician Insurers Association of America, Rockville (MD)
88. Croskerry P. Achilles heels of the ED: delayed or missed diagnoses. ED Legal Letter (October 2003) 109-120
89. Freas G.C. Medicolegal aspects of acute myocardial infarction. Emerg Med Clin North Am 19 2 (2001) 511-521
90. Chen K., Varon J., Wenker O., et al. Acute thoracic aortic dissection: the basics. J Emerg Med 15 6 (1997) 859-867
91. Meszaros I., Morocz J., Szlavi J., et al. Epidemiology and clinicopathology of aortic dissection. Chest 117 5 (2000) 1271-1278
92. Kouchokis N., and Dougenis D. Surgery of the thoracic aorta. N Engl J Med 336 26 (1997) 1876-1888
93. Hagan P.G., Nienaber C.A., Isselbaher E.M., et al. The international registry of acute aortic dissection (IRAD). JAMA 283 7 (2000) 897-903
94. Slater E., and DeSanctis R.W. The clinical recognition of dissecting aortic aneurysm. Am J Med 60 (1976) 625-633
95. Massumi A., and Mathur V.S. Clinical recognition of aortic dissection. Tex Heart Inst J 17 (1990) 254-256
96. Levinson D., Edmeades D., and Griffith G. Dissecting aneurysm of the aorta: its clinical electrocardiographic and laboratory findings. Circulation 1 (1950) 360-387
97. Von Kodolitsch Y., Loose R., Ostermeyer J., et al. Proximal aortic dissection late after aortic valve surgery: 119 cases of a distinct clinical entity. Thorac Cardiovasc Surg 48 (2000) 342-346
98. Crawford E.S. The diagnosis and management of aortic dissection. JAMA 264 (1990) 2537-2541
99. Bordeleau L., Cwinn A., Turek M., et al. Aortic dissection and Turner's syndrome: case report and review of the literature. J Emerg Med 16 (1998) 593-596
100. Sullivan P.R., Wolfson A.B., Leckey R.D., et al. Diagnosis of acute thoracic aortic dissection in the emergency department. Am J Emerg Med 18 (2000) 46-50
101. Pesola G.R., Pesola H.R., Lin M., et al. The normal difference in bilateral indirect blood pressure recordings in hypertensive individuals. Acad Emerg Med 9 (2002) 342-345
102. Singer A.J., and Hollander J.E. Blood pressure: assessment of interarm differences. Arch Intern Med 156 (1996) 2005-2008
103. Rosman H.S., Patel S., Bzorak S., et al. Quality of history taking in patients with aortic dissection. Chest 114 (1998) 793-795
104. Hirata K., Kyushima M., and Asato H. Electrocardiographic abnormalities in patients with acute aortic dissection. Am J Cardiol 76 (1995) 1207-1212
105. Ohtani H., Kiyokawa K., Asada H., et al. Stanford type A acute dissection developing acute myocardial infarction. Jpn J Thorac Cardiovasc Surg 48 (2000) 69-72
106. Gregorio M.C., Baumgartner F.J., and Omari B.O. The presenting chest roentgenogram in acute type A aortic dissection: a multidisciplinary study. Am Surg 68 1 (2002) 6-10
107. Sommer T., Fehske W., Holzknecht N., et al. Aortic dissection: A comparative study of diagnosis with spiral CT, multiplanar transesophageal echocardiography, and MR imaging. Radiology 199 (1996) 347-352
108. Moore AG, Eagle KA, Bruckman D, et al. Choice of computed tomography, transesophageal echocardiography, magnetic resonance imaging and aortography in acute aortic dissection: International registry of acute aortic dissection (IRAD). Am J Cardiol 202(89):1235-7.
109. Silvey S.V., Stoughton T.L., Pearl W., et al. Rupture of the outer partition of aortic dissection during transesophageal echocardiography. Am J Cardiol 68 2 (1991) 286-287
110. Hayter R.G., Rhea J.T., Small A., et al. Suspected aortic dissection and other aortic disorders: Multi-detector CT in 373 cases in the emergency setting. Radiology 238 3 (2006) 841-852
111. Weber T., Högler S., Auer J., et al. D-dimer in acute aortic dissection. Chest 123 (2003) 1375-1378
112. Perez A., Abbet P., and Drescher M.J. D-dimers in the emergency department evaluation of aortic dissection. Acad Emerg Med 11 (2004) 397-400
113. Eggebrecht H., Naber C.K., Bruch C., et al. Value of plasma fibrin D-dimers for detection of acute aortic dissection. J Am Coll Cardiol 44 (2004) 804-809
114. Wiegand J., Koller M., and Bingisser R. Does a negative D-dimer test rule out aortic dissection?. Swiss Med Wkly 137 (2007) 462
115. Sodeck G., Domanovits H., Schillinger M., et al. D-dimer in ruling out acute aortic dissection: A systematic review and prospective cohort study. Eur Heart J 28 (2007) 3067-3075
116. Sutherland A., Escano J., and Coon T.P. D-dimer as the sole screening test for acute aortic dissection: A review of the literature. Ann Emerg Med 52 4 (2008) 339-343
117. Suzuki T., Katoh H., Tsuchio, et al. Diagnostic implications of elevated levels of smooth-muscle myosin heavy-chain protein in acute aortic dissection. Ann Intern Med 133 7 (2000) 537-541
118. Januzzi J.L., Isselbacher E.M., Fatorri R., et al. Characterizing the young patient with aortic dissection: results from the international registry of aortic dissection (IRAD). [abstract 1081-154]. J Am Coll Cardiol 41 6 (2003) 235A
119. Hansen M.S., Nogareda G.J., and Hutchison S.J. Frequency of and inappropriate treatment of misdiagnosis of acute aortic dissection. Am J Cardiol 99 (2007) 852-856
120. Spittell P.C., Spittell J.A., Joyce J.W., et al. Clinical features and differential diagnosis of aortic dissection: Experience with 236 cases (1980 through 1990). Mayo Clin Proc 68 (1993) 642-651
121. Cohen S., and Littman D. Painless dissecting aneurysm of the aorta. N Engl J Med 271 (1964) 143-145
122. Alsous F., Silam A., Ezeldin A., et al. Potential pitfalls in the diagnosis of aortic dissection. Conn Med 67 3 (2003) 131-134
123. Nallamothu B.K., and Eagle K.A. When zebras run with the horses: The diagnostic dilemma of acute aortic dissection complicated by myocardial infarction. J Interv Cardiol 15 (2002) 297-300
124. Piney S.P., and Wasserman H.S. Anterior myocardial infarction, acute aortic dissection and anomalous coronary artery. J Interv Cardiol 15 (2002) 293-296
125. Elefteriades J.A., Barrett P.W., and Kopf G.S. Litigation in nontraumatic aortic diseases-a tempest in the malpractice maelstrom. Cardiology 109 (2008) 263-272
126. Spencer F.A., Emery C., Lessard D., et al. The Worcester Thromboembolism Study. A population-based study of the clinical epidemiology of venous thromboembolism. J Gen Intern Med 21 (2006) 722-727
127. Goldhaber S.Z., Visani L., and De Rosa M. Acute pulmonary embolism: clinical outcomes in the International Cooperative Pulmonary Embolism Registry (ICOPER). Lancet 353 (1999) 1386-1389
128. Heit J.A., O'Fallon W.M., Petterson T.M., et al. Relative impact of risk factors for deep vein thrombosis and pulmonary embolism. Arch Intern Med 162 (2002) 1245-1248
129. Becattini C., and Agnelli G. Acute pulmonary embolism: risk stratification in the emergency department. Intern Emerg Med 2 (2007) 119-129
130. Task force on pulmonary embolism. European section of cardiology. Guidelines on diagnosis and management of acute pulmonary embolism. Eur Heart J 21 (2001) 1301-1336
131. Stein P.D., Beemath A., Matta F., et al. Clinical characteristics of patients with acute pulmonary embolism: data from PIOPED II. Am J Med 120 (2007) 871-879
132. Clinical Policy. Critical issues in the evaluation and management of adult patients presenting with suspected pulmonary embolism. Ann Emerg Med 41 2 (2003) 257-270
133. Wells P.S., Ginsberg J.S., Anderson D.R., et al. Use of a clinical model for safe management of patients with suspected pulmonary embolism. Ann Intern Med 129 (1988) 997-1005
134. Wicki J., Pereger T., Junod A., et al. Assessing clinical probability of pulmonary embolism in the emergency ward: a simple score. Arch Intern Med 161 (2001) 92-97
135. Sanson B.-J., Lijmer J.G., Gillavry M.R.M., et al. Comparison of a clinical probability estimate and 2 clinical models in patients with suspected pulmonary embolism. Thromb Haemost 83 (2000) 199-203
136. Stein P.D., and Henry J.W. Clinical characteristics of patients with acute pulmonary embolism stratified according to their presenting syndromes. Chest 112 (1997) 974-979
137. Elliot C.G., Goldhaber S.Z., Visani L., et al. Chest radiographs in acute pulmonary embolism. Chest 118 (2000) 33-38
138. Stein P.D., Hull R.D., Patel K.C., et al. D-dimer for the exclusion of acute venous thrombosis and pulmonary embolism: a systematic review. Ann Intern Med 140 8 (2004) 589-602
139. Tapson V.F., Carroll B.A., Davidson B.L., et al. The diagnostic approach to acute venous thromboembolism. Clinical practice guidelines. American Thoracic Society. Am J Respir Crit Care Med 160 (1999) 1043-1066
140. Kearon C., Ginsberg J.S., Jouketis J., et al. An evaluation of D-dimer in the diagnosis of pulmonary embolism: a randomized trial. Ann Intern Med 144 11 (2006) 812-821
141. Brown M.D., Vance S.J., and Kline J.A. An emergency department guideline for the diagnosis of pulmonary embolism: an outcome study. Acad Emerg Med 12 1 (2005) 20-25
142. Hogg K., Dawson D., and Mackway-Jones K. The emergency department utility of Simplify D-dimer™ to exclude pulmonary embolism in patients with pleuritic chest pain. Ann Emerg Med 46 4 (2005) 305-310
143. Kutinsky I., Blakely S., Roche V., et al. Normal D-dimer levels in patients with pulmonary embolism. Arch Intern Med 159 (1999) 1569-1572
144. Brown M.D., Rowe B.H., Reeves M.J., et al. The accuracy of the enzyme-linked immunosorbent assay D-dimer test in the diagnosis of pulmonary embolism: a meta-analysis. Ann Emerg Med 40 (2002) 133-144
145. Kabrhel C. Outcomes of high pretest probability patients undergoing D-dimer testing for pulmonary embolism: a pilot study. J Emerg Med 35 4 (2008) 373-377
146. Chabloz P., Reber G., Boehlen F., et al. TAFI antigen and D-dimer levels during normal pregnancy and at delivery. Br J Haematol 115 (2001) 150-152
147. Righini M., Goehring C., Bounameaux H., et al. Effects of age on the performance of common diagnostic tests for pulmonary embolism. Am J Med 109 (2000) 357-361
148. ten Wolde M., Kraaijenhagen R.A., Prins M.H., et al. The clinical usefulness of D-dimer testing in cancer patients with suspected deep venous thrombosis. Arch Intern Med 162 (2002) 1880-1884
149. Quiroz R., Kucher N., Zou K.H., et al. Clinical validity of a negative computed tomography scan in patients with suspected pulmonary embolism. JAMA 293 (2005) 2012-2017
150. Stein P.D., Fowler S.E., Goodman L.R., et al. Multidetector computed tomography for acute pulmonary embolism. N Engl J Med 354 (2006) 2317-2327
151. Van Belle A., Büller H.R., Huisman M.V., et al. Effectiveness of managing suspected pulmonary embolism using an algorithm combining clinical probability, D-dimer testing, and computed tomography. JAMA 295 (2006) 172-179
152. Perrier A., Roy P.M., Sanchez O., et al. Multidetector-row computed tomography in suspected pulmonary embolism. N Engl J Med 28 (2005) 1760-1768
153. Stone S.E., and Morris T.A. Pulmonary embolism during and after pregnancy. Crit Care Med 33 10 (2005) S294-S300
154. Chunilal S.D., Wikelboom J.W., Attia J., et al. Does this patient have pulmonary embolism?. JAMA 290 21 (2003) 2849-2858
155. Timmons S., Kingston M., Hussain M., et al. Pulmonary embolism: differences in presentation between older and younger patients. Age Ageing 32 (2003) 601-605
156. The PIOPED investigators. Value of the ventilation/perfusion scan in acute pulmonary embolism: results of the Prospective Investigation of Pulmonary Embolism Diagnosis (PIOPED). JAMA 263 (1990) 1753-1759
157. Carson J.L., Kelle M.A., Duff A., et al. The clinical course of pulmonary embolism. N Engl J Med 326 19 (1992) 1240-1245
158. Stein P.D., Sostman H.D., Bounameaux H., et al. Challenges in the diagnosis of acute pulmonary embolism. Am J Med 121 7 (2008) 565-571
159. Boie E.T. Initial evaluation of chest pain. Emerg Med Clin North Am 23 (2005) 937-957
160. Holloway V.J., and Harris J.K. Spontaneous pneumothorax: is it under tension?. J Accid Emerg Med 17 (2000) 222-223
161. Currie G.P., Alluri R., Christie G.L., et al. Pneumothorax: an update. Postgrad Med J 83 (2007) 461-465
162. Weissberg D., and Refaely Y. Pneumothorax: experience with 1,199 patients. Chest 117 5 (2005) 1279-1285
163. Leigh-Smith S., and Harris T. Tension pneumothorax-time for a rethink?. Emerg Med J 22 (2005) 8-16
164. Jones R., and Hollingsworth J. Tension pneumothorax not responding to needle thoracocentesis. Emerg Med J 19 (2002) 176-177
165. Griffin S.M., Lamb P.J., Shenfine J., et al. Spontaneous rupture of the oesophagus. Br J Surg 95 (2008) 1115-1120
166. Eroglu A., Kurkcuoglu I.C., Karaoglanoglu N., et al. Esophageal perforation: the importance of early diagnosis and primary repair. Dis Esophagus 17 (2004) 91-94
167. Lemke T., and Jagminas L. Spontaneous esophageal rupture: a frequently missed diagnosis. Am Surg 65 (1999) 449-452
168. Rubesin S.E., and Levin M.S. Radiologic diagnosis of gastrointestinal perforation. Radiol Clin North Am 41 (2003) 1095-1115
169. White C.S., Templeton P.A., and Attar S. Esophageal perforation: CT findings. AJR Am J Roentgenol 160 (1993) 767-770
170. Nadrous H.F., Afess B., Pfeifer E.A., et al. The role of autopsy in the intensive care unit. Mayo Clin Proc 78 (2003) 947-950
171. Mamas M.A., Nair S., and Fraser D. Cardiac tamponade and heart failure as a presentation of influenza. Exp Clin Cardiol 12 4 (2007) 214-216
172. Gladych E., Goland S., Attali M., et al. Cardiac tamponade as a manifestation of tuberculosis. Southampt Med J 94 5 (2001) 525-528
173. Goldberger Z.D., and Loge A.S. Three's company: an unusual clue. Am J Med 121 9 (2008) 774-776
174. Fejka M., Dixon S.R., Safian R.D., et al. Diagnosis, management, and clinical outcome of cardiac tamponade complicating percutaneous coronary intervention. Am J Cardiol 90 (2002) 1183-1186
175. Gerson T., Kuruppu J., and Olshaker J. Delayed cardiac tamponade after pacemaker insertion. J Emerg Med 18 3 (2000) 355-359
176. Roy C.L., Minor M.A., Brookhart M.A., et al. Does this patient with a pericardial effusion have a cardiac tamponade?. JAMA 297 16 (2007) 1810-1818
177. Brown J., MacKinnon D., King A., et al. Elevated arterial blood pressure in cardiac tamponade. N Engl J Med 327 7 (1992) 463-466
178. Hoit B.D. Pericardial disease and pericardial tamponade. Crit Care Med 35 8 Suppl (2007) S355-S364
179. Curtiss E.I., Reddy P.S., Uretsky B.F., et al. Pulsus paradoxus: definition and relation to the severity of cardiac tamponade. Am Heart J 115 2 (1988) 385-390
180. Merce J., Sagrista-Sauleda J., Permanyer-Miralda G., et al. Correlation between clinical and Doppler echocardiographic findings in patients with moderate and large pericardial effusion: implications for the diagnosis of cardiac tamponade. Am Heart J 138 (1999) 759-764
181. Guntheroth W.G. Sensitivity and specificity of echocardiographic evidence of tamponade: implications for ventricular interdependence and pulsus paradoxus. Pediatr Cardiol 28 (2007) 358-362