Nondiagnostic ECG During Symptoms Does Not Rule Out ACS

Rates of ACS, AMI, and adverse outcomes were similar in patients with and without symptoms.

A commonly held emergency medicine belief is that if an electrocardiogram is normal while a patient has chest pain, the chest pain must not be caused by acute coronary syndrome (ACS). The authors of this study assessed the risk of ACS in patients who had a normal or nonspecific ECG while experiencing chest pain.

In a prospective cohort study, 2007 patients aged 24 and older who presented to a single emergency department with symptoms suggestive of ACS were contacted by telephone at 30 days to determine outcomes (acute myocardial infarction or ACS during admission and 30-day cardiovascular events, including AMI, revascularization, or death). Overall, 1196 patients were symptomatic when the ECG was obtained, and 811 were not. There were no sig…

Reviewing Author

Diane M. Birnbaumer, MD, FACEP