Abstract
Background: In emergency department (ED), though electrocardiogram (ECG) is obtained for both typical and atypical chest pain, at certain times, it is overutilized even in patients with low-risk factors for acute coronary syndrome (ACS). This study aimed to assess the utility of an ECG in patients presenting with chest pain to the ED. Materials and Methods: This prospective study included patients presenting with chest pain to the ED during August and September 2018. Following their initial assessment at triage, patients were grouped into high-, intermediate- and low-risk categories based on their risk factors for an ACS. ECGs were acquired and categorized into ACS and non-ACS pattern and their utility in each group was assessed. Results: This study cohort contains 313 patients with a male predominance 59.1%. The mean age was 52.6 ± 15.2 years. Typical chest pain was prominent in 95 (30.4%) patients. The incidence of ischemic and structural heart diseases was 53 (16.9%) and 31 (9.9%), respectively. ACS was diagnosed in 92 (29.3%) patients; among them, ST-elevation myocardial infarction (STEMI), non-ST-elevation myocardial infarction (NSTEMI), and unstable angina were noted to be 51 (16.3%), 27 (8.6%), and 14 (4.5%), respectively. The incidence of ACS based on risk category classification was as follows: high risk 38.9% (44/113) and intermediate risk 33.8% (48/142) and no patients in low risk had ACS. Conclusions: ECG though a useful screening test to diagnose ACS, should be used judiciously in patients with low risk of ACS to optimally utilize the limited resources in ED.
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.