What decides the suspicion of acute coronary syndrome in acute chest pain patients?
Why the study?
What are the relative contributions of symptoms, ECG, and TnT to the ED physician's evaluation of ACS likelihood in patients with acute chest pain?
Population
1151 consecutive emergency department patients presenting with acute chest pain
Design
Cohort
Authors
Discussion
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Member takes
Implication
Symptoms drive ED ACS suspicion far more than ECG or troponin; this observational association leaves open prospective outcome validation.
Structured PICO
What are the relative contributions of symptoms, ECG, and TnT to the ED physician's evaluation of ACS likelihood in patients with acute chest pain?
P
Population
1151 consecutive emergency department patients presenting with acute chest pain
I
Intervention
Clinical assessment using symptom history, ECG, and troponin T (TnT)
O
Outcome
ED physician's subjective assessment of the patient's likelihood of ACS (obvious ACS, strong, vague or no suspicion of ACS)
In the emergency department, physicians rely primarily on patient symptoms rather than ECG or troponin levels to determine the overall likelihood of acute coronary syndrome.
Cite This Study
Kamali et al. (2014) studied this question.