American heart journal
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American heart journal · May 2005
Comparative StudyAssessment of patients with low-risk chest pain in the emergency department: Head-to-head comparison of exercise stress echocardiography and exercise myocardial SPECT.
The aim of the study was to compare head-to-head the performance of exercise tolerance test-stress echocardiography (ex-Echo) and exercise stress-perfusion nuclear imaging (exercise-single-photon emission computed tomography [ex-SPECT]) for the diagnosis of coronary artery disease (CAD) in patients evaluated at the chest pain unit with delay from chest pain (CP) onset. ⋯ Ex-Echo can be an effective diagnostic strategy in the early triage of CP patients, improving diagnosis in case of (-)ex-ECG and reducing unnecessary angiography number. Its drawback is represented by the 5% of missed diagnosis.
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American heart journal · May 2005
Impact of the application of the American College of Emergency Physicians recommendations for the admission of patients with syncope on a retrospectively studied population presenting to the emergency department.
The goal of our study was to determine the accuracy of the American College of Emergency Physicians (ACEP) clinical policy in identifying patients with a cardiac cause for their syncope and its potential effect on syncope management. ⋯ High sensitivity and specificity in identifying patients with cardiogenic syncope and significant reduction in the hospital admission rate were observed by applying ACEP level B recommendations to patients presenting to our ED. Application of level C recommendations did not offer any advantage.