Risk stratification of emergency department patients with chest pain: The need for standardized reporting guidelines

Abstract

Annually, 14 million ECGs are obtained on patients in US emergency departments (EDs), up to 6 million patients are evaluated for potential acute coronary syndromes, and there are more than 3 million ED visits with a primary diagnosis of acute chest pain. As a result, a high percentage of emergency medicine research is focused on the risk stratification of patients with potential acute coronary syndromes. A MEDLINE search using the terms “myocardial infarction” or “unstable angina” and “risk stratification” identified more than 175 articles in the past 2 years alone. Despite all this research, researchers cannot identify a large group of ED chest pain patients with less than 1% risk for short-term adverse cardiovascular events.