Prognosis of Low-Risk Young Women Presenting to the Emergency Department With Chest Pain

Identification of patients at low risk presenting to the emergency department with chest pain is a continuing challenge. We examined a cohort of low-risk women with negative cardiac injury markers, electrocardiogram with normal results, and clinical stability. We hypothesized that these patients can...

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Bibliographic Details
Published in:The American journal of cardiology 2016-01, Vol.117 (1), p.36-39
Main Authors: Stauber, Stacey M., BS, Teleten, Aleksander, PA, Li, Zhongmin, PhD, Venugopal, Sandhya, MD, Amsterdam, Ezra A., MD
Format: Article
Language:English
Subjects:
Adult
Cardiac Catheterization
Cardiology
Cardiovascular
Chest Pain - diagnosis
Electrocardiography
Emergency Service, Hospital - statistics & numerical data
Exercise Test
Female
Heart attacks
Hospitalization - trends
Humans
Medical imaging
Middle Aged
Prognosis
Retrospective Studies
Risk Factors
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Summary:Identification of patients at low risk presenting to the emergency department with chest pain is a continuing challenge. We examined a cohort of low-risk women with negative cardiac injury markers, electrocardiogram with normal results, and clinical stability. We hypothesized that these patients can be safely and accurately managed in a chest pain unit (CPU), may not require predischarge cardiac testing, and have an excellent short-term prognosis. The primary end point was major cardiovascular events during index admission or follow-up. Mean age of the 403 women was 42 ± 4.3 years (30 to 50 years). No patient had a cardiovascular event in the CPU, and none of the 321 patients followed for 6 months had a late cardiovascular event. Most (211, 52%) did not receive predischarge cardiac testing. The remaining 192 patients (48%) had predischarge exercise treadmill test, stress imaging, or cardiac catheterization. Of those patients who underwent treadmill testing, almost 90% had no exercise-induced chest pain and approximately 50% had functional capacity 8 to 14 METs. In addition, 166 patients (41%) were discharged from the CPU after
ISSN:0002-9149
1879-1913
DOI:10.1016/j.amjcard.2015.09.045