Does My Patient Have Acute Coronary Syndrome?

When used in aggregate risk scores, clinical findings can identify or exclude ACS effectively.

Promptly and accurately estimating the clinical probability of acute coronary syndrome (ACS) allows better triage and management of high-risk patients and prevents unnecessary observation and work-up of lower-risk patients. In this meta-analysis, researchers evaluated 58 prospective emergency department studies that involved diagnostic test accuracy among patients with suspected ACS but no initial ST-segment elevation on electrocardiograms (ECGs).

Clinical findings that portended excess ACS risk included hypotension (systolic blood pressure, <100 mm Hg; positive likelihood ratio, 3.9), abnormal prior stress test (LR, 3.1), peripheral artery disease (LR, 2.7), radiation to both arms (LR, 2.6), and pain similar to prior ischemia (LR, 2.2). ECG…

Reviewing Authors

Geoffrey Southmayd, MD

Daniel D. Dressler, MD, MSc, SFHM, FACP

Disclosures

RoyaltiesMcGraw-Hill; Elsevier

Editorial BoardsMedical Clinics of North America; Caribbean Medical Journal International Advisory Panel (2021–2026)

Daniel D. Dressler, MD, MSc, SFHM, FACP

Disclosures

RoyaltiesMcGraw-Hill; Elsevier

Editorial BoardsMedical Clinics of North America; Caribbean Medical Journal International Advisory Panel (2021–2026)

Does My Patient Have Acute Coronary Syndrome?

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Reviewing Authors