Acad Emerg Med. 2016 Jun 22. doi: 10.1111/acem.13038. [Epub ahead of print]
- 1Department of Emergency Medicine, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157.
Abstract
Care patterns for Emergency Department (ED) patients with acute chest pain are changing rapidly. Just a few years ago patients at very-low risk for acute coronary syndrome (ACS) were routinely admitted to the hospital or placed in an observation unit for serial troponins (cTn) and stress testing or computed tomography (CT) coronary angiography. These conservative practices were fueled by American College of Cardiology/American Heart Association guidelines, malpractice fears, and the TIMI and GRACE Scores which lack sensitivity and are not designed for ED use.1-4 Since that time, the derivation and validation of accelerated diagnostic protocols (ADPs), has led to low-risk patients being discharged from EDs with greater frequency.
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