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European Heart Journal Advance Access originally published online on June 21, 2005
European Heart Journal 2005 26(16):1573-1575; doi:10.1093/eurheartj/ehi381
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© The European Society of Cardiology 2005. All rights reserved. For Permissions, please e-mail: journals.permissions@oupjournals.org

Detecting acute coronary syndrome in the emergency department: the answer is in seeing the heart: why look further?

Roxy Senior* and Houman Ashrafian

Department of Cardiovascular Medicine, Northwick Park Hospital, Watford Road, Harrow, Middlesex HA1 3UJ, UK

* Corresponding author. Tel: +44 208 869 2548; fax: +44 208 864 0075. E-mail address: roxy.senior@virgin.net

This editorial refers to ‘Regional left ventricular perfusion and function in patients presenting to the emergency department with chest pain and no ST-segment elevation’{dagger} by D. Rinkevich et al., on page 1606

The first 10% of the full text of this article appears below.

The emergent assessment of chest pain continues to represent a major medical challenge. In the USA alone, 6 million patients annually present to emergency departments with chest pain. The time-honoured application of clinical assessment, electrocardiography, and markers of myocardial injury (e.g. troponins) definitively identify only 20–30% of patients with acute coronary syndrome (ACS); indeed, biochemical markers are frequently normal in the early hours of pain. Conversely, many admissions pending normal results are unnecessary and take much of the patient time and cause anxiety as well as costing billions of dollars. Worryingly, ~5% of patients with ACS are discharged inadvertently, representing a source of significant mortality (~25%) and litigation. Therefore, there is an urgent demand for effective risk stratification tools.

Can pathophysiological principles help identify the ideal test? A direct relationship between . . . [Full Text of this Article]


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Related articles in EHJ:

Regional left ventricular perfusion and function in patients presenting to the emergency department with chest pain and no ST-segment elevation
Diana Rinkevich, Sanjiv Kaul, Xin-Qun Wang, Khim Leng Tong, Todd Belcik, Saul Kalvaitis, Wolfgang Lepper, John M. Dent, and Kevin Wei
EHJ 2005 26: 1606-1611. [Abstract] [FREE Full Text]  



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