The utility of an electrocardiogram in high-, intermediate-, and low-risk patients presenting with chest pain to emergency department
| Autor: | M Sanjay, Anju Susan Kurien, Merin Hanna Abraham, Abraham Speedie |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2023 |
| Předmět: | |
| Zdroj: | Current Medical Issues, Vol 21, Iss 1, Pp 44-49 (2023) |
| Druh dokumentu: | article |
| ISSN: | 0973-4651 2666-4054 |
| DOI: | 10.4103/cmi.cmi_102_22 |
| Popis: | 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. |
| Databáze: | Directory of Open Access Journals |
| Externí odkaz: |
|