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Journal of Nuclear Cardiology
Published in: Journal of Nuclear Cardiology 4/2020

01-08-2020 | Stress Echocardiography | Editorial

All Together Now: Synthesizing Evidence-Based Protocols to Simplify and Expedite Emergency Department Evaluation of Low-Risk Patients

Authors: Nishant R. Shah, MD, MPH, MSc, Marcio S. Bittencourt, MD, PhD, MPH, David E. Winchester, MD, MS

Published in: Journal of Nuclear Cardiology | Issue 4/2020

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Excerpt

Patients with chest pain account for a substantial number of emergency department (ED) visits.1 While early identification of acute coronary syndrome (ACS) in these patients is essential, current guidelines also support rapid identification and safe discharge of patients at low risk of ACS.2-4 In these low-risk patients, noninvasive cardiac testing modes—specifically exercise treadmill testing (ETT), stress single-photon emission CT (SPECT) myocardial perfusion imaging (MPI), stress positron emission tomography (PET) MPI, cardiac CT angiography (CCTA), or stress echocardiography—are currently recommended prior to or within 72 hours after ED-discharge.2 …
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Amsterdam EA, Wenger NK, Brindis RG, et al. 2014 AHA/ACC guideline for the management of patients with non-ST-elevation acute coronary syndromes: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation 2014;130(25):e344-426.PubMed
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Backus BE, Six AJ, Kelder JC, et al. A prospective validation of the HEART score for chest pain patients at the emergency department. Int J Cardiol 2013;168(3):2153-8.CrossRef
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Ferencik M, Mayrhofer T, Lu MT, et al. High-sensitivity cardiac troponin i as a gatekeeper for coronary computed tomography angiography and stress testing in patients with acute chest pain. Clin Chem 2017;63(11):172433.CrossRef
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Hoffmann U, Ferencik M, Udelson JE, et al. Prognostic value of noninvasive cardiovascular testing in patients with stable chest pain: insights from the PROMISE trial (prospective multicenter imaging study for evaluation of chest pain). Circulation 2017;135(24):2320-32.CrossRef
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Fordyce CB, Newby DE, Douglas PS. Diagnostic strategies for the evaluation of chest pain: Clinical implications from SCOT-HEART and PROMISE. J Am Coll Cardiol 2016;67(7):843-52.CrossRef
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Metadata
Title
All Together Now: Synthesizing Evidence-Based Protocols to Simplify and Expedite Emergency Department Evaluation of Low-Risk Patients
Authors
Nishant R. Shah, MD, MPH, MSc
Marcio S. Bittencourt, MD, PhD, MPH
David E. Winchester, MD, MS
Publication date
01-08-2020
Publisher
Springer International Publishing
Published in
Journal of Nuclear Cardiology / Issue 4/2020
Print ISSN: 1071-3581
Electronic ISSN: 1532-6551
DOI
https://doi.org/10.1007/s12350-019-01858-x

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