Patients with Negative ED Evaluations for Chest Pain Rarely Have In-Hospital Adverse Cardiac Events

Among admitted patients with two negative troponin measurements, nonischemic ECGs, and normal vital signs, fewer than 0.1% had clinically relevant events.

Many patients treated for chest pain in U.S. emergency departments (EDs) are admitted to observation or inpatient units for monitoring of potential adverse cardiac events and provocative testing. In a review of medical records from three hospitals, researchers quantified the risk for such events — a composite of inpatient ST-segment elevation myocardial infarction, serious arrhythmia, cardiac or respiratory arrest, and death — in ED patients who presented with chest pain/pressure/tightening/burning and had serial negative troponin measurements (1 to 7 hours apart).

Of 11,230 patients, 20 (0.2%) had clinically relevant adverse cardiac events. After exclusion of patients with abnormal vital signs, ischemic electrocardiogram findings, left bund…

Reviewing Author

Ali S. Raja, MD, MBA, MPH, FACEP

Disclosures

Leadership Positions in Professional SocietiesSociety for Academic Emergency Medicine (Board Member); American College of Healthcare Executives – Massachusetts (Board Member)

Ali S. Raja, MD, MBA, MPH, FACEP

Disclosures

Leadership Positions in Professional SocietiesSociety for Academic Emergency Medicine (Board Member); American College of Healthcare Executives – Massachusetts (Board Member)

Patients with Negative ED Evaluations for Chest Pain Rarely Have In-Hospital Adverse Cardiac Events

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Reviewing Author