Many ED Patients Are Noncompliant with Outpatient Exercise Stress Testing

Emergency department patients with chest pain who are at low risk for acute coronary syndrome commonly are referred for outpatient exercise stress testing (EST), but do they follow up? In a prospective Canadian study, a convenience sample of low-risk chest pain patients being discharged from the ED were randomized to either a control group (107 patients), in which patients were told to contact their physicians directly to arrange an EST, or an intervention group (120 patients), in which ED staff ordered the outpatient EST at the time of discharge. Eligible patients had normal electrocardiogram findings, normal cardiac enzymes at least 6 hours after symptom onset, and no history of ischemic heart disease.

At 30 days, significantly more interv…