Stress Testing Has Low Yield in Young Adults with Chest Pain

To assess the yield of extended observation and testing of young patients with chest pain, researchers examined test results and adverse cardiac events within 1 year among 362 patients aged 18 to 40 (49% men; 55% black) who were evaluated for suspected acute coronary syndrome in an emergency department (ED)-based cardiac observation unit.

Of the 362 patients, 124 had negative serial cardiac marker results and were discharged directly from the ED, and 238 underwent further testing. Fifteen patients had abnormal work-ups; one had elevated troponin and normal angiography but was discharged with a diagnosis of myocardial infarction (MI), and 14 patients had abnormal stress test results. Five stress test results were positive and nine were consid…