Normal ECG During Chest Pain Does Not Rule Out ACS

Among chest pain patients with normal initial ECGs, a similar percentage had acute coronary syndrome whether the ECG was performed when chest pain was present or absent.

A normal electrocardiogram does not exclude acute coronary syndrome (ACS) in patients who present with chest pain, but many clinicians believe that ACS is unlikely to be the cause of the chest pain if the normal ECG was obtained during a pain episode. To clarify this issue, these authors conducted a prospective, observational study of 387 patients who presented to an emergency department with chest pain, had normal initial ECGs, and were admitted for evaluation for ACS.

Patients were divided into two groups, based on whether they had active chest pain during acquisition of the normal initial ECG: 126 had chest pain and 261 did not. ACS was defined as non–ST-segment-elevation myocardial infarction, >70% stenosis on coronary angiography, or po…

Reviewing Author

Diane M. Birnbaumer, MD, FACEP

Disclosures

Consultant / Advisory boardSecurisyn

Editorial boardsThe Merck Manuals (Home and Physician Editions)

Diane M. Birnbaumer, MD, FACEP

Disclosures

Consultant / Advisory boardSecurisyn

Editorial boardsThe Merck Manuals (Home and Physician Editions)