Clinical cardiology
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Clinical cardiology · Nov 2007
Initial presenting electrocardiogram as determinant for hospital admission in patients presenting to the emergency department with chest pain: a pilot investigation.
Evaluation of chest pain accounts for millions of costly Emergency Department (ED) visits and hospital admissions annually. Of these, approximately 10-20% are myocardial infarctions (MI). ⋯ Patients with chest pain and initial ECGs with ST segment abnormalities suggestive or diagnostic for ischemia, should be admitted to the hospital for further evaluation and management. Patients with ECGs that do not display acute ST segment changes are at a lower risk for acute myocardial infarction than those with acute ST segment changes and should be admitted on the basis of cardiac risk profile. (i.e., age, gender, hypertension, diabetes, smoking, known coronary artery disease, etc.) Patients with normal ECGs (category 1) are at extremely low risk, and it may be acceptable to consider further evaluation on an outpatient basis.