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Patients with acute coronary syndromes (ACS) present with a wide variety of symptoms. Investigators at a single center in New York City conducted a retrospective study involving 2525 patients with no previous history of myocardial infarction or coronary revascularization who were evaluated for ACS in an emergency department–based chest pain unit. Typical angina was defined as “the presence of substernal chest pain or discomfort that was provoked by exertion or emotional stress and was relieved by rest and/or nitroglycerin.” All patients underwent provocative stress testing after serial biomarkers were obtained.
Presenting symptoms did not vary significantly by sex, age, or history of diabetes. Ischemia was induced by stress testing in 14% of…