Article Instance

HTTP 200 OK
Allow: GET
Content-Type: application/json
Vary: Accept

{
    "pk": 17657,
    "title": "Echocardiography to Supplement Stress Electrocardiography in Emergency Department Chest Pain Patients",
    "subtitle": null,
    "abstract": "Introduction: Chest pain (CP) patients in the Emergency Department (ED) present a diagnostic dilemma, with a low prevalence of coronary disease but grave consequences with misdiagnosis. A common diagnostic strategy involves ED cardiac monitoring while excluding myocardial necrosis, followed by stress testing. We sought to describe the use of stress echocardiography (echo) at our institution, to identify cardiac pathology compared with stress electrocardiography (ECG) alone.\n\n\nMethods: Retrospective cohort study of 57 urban ED Chest Pain Unit (CPU) patients from 2002-2005 with stress testing suggesting ischemia. Our main descriptive outcome was proportion and type of discordant findings between stress ECG testing and stress echo. The secondary outcome was whether stress echo results appeared to change management.\n\n\nResults: Thirty-four of 57 patients [59.7%, 95% confidence interval (CI) 46.9-72.4%] had stress echo results discordant with stress ECG results. The most common discordance was an abnormal stress ECG with a normal stress echo (n=17/57, 29.8%, CI 17.9-41.7%), followed by normal stress ECG but with reversible regional wall-motion abnormality on stress echo (n = 10/57, 17.5%, CI 7.7-27.4%). The remaining seven patients (12.3%, CI 3.8-20.8%) had non-diagnostic stress ECG due to sub-maximal effort. Stress echo showed reversible wall-motion abnormality in two, and five were normal. Twenty-five of the 34 patients (73.5%, CI 56.8-85.4%) with discordant results had a different diagnostic strategy than predicted from their stress ECG alone.\n\n\nConclusion: The addition of echo to stress ECG testing in ED CPU patients altered diagnosis in 34/57 (59.7%, CI 46.9-72.4%) patients, and appeared to change management in 25/57 (43.9%, CI 31.8-57.6%) patients. [West J Emerg Med. 2010; 11(4):379-383.]",
    "language": "en",
    "license": {
        "name": "Creative Commons Attribution-NonCommercial  4.0",
        "short_name": "CC BY-NC 4.0",
        "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNonCommercial — You may not use the material for commercial purposes.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.",
        "url": "https://creativecommons.org/licenses/by-nc/4.0"
    },
    "keywords": [
        {
            "word": "stress echo"
        },
        {
            "word": "stress ECG"
        },
        {
            "word": "Chest Pain Unit"
        },
        {
            "word": "Emergency Medicine"
        }
    ],
    "section": "Article",
    "is_remote": true,
    "remote_url": "https://escholarship.org/uc/item/5r61g4bj",
    "frozenauthors": [
        {
            "first_name": "Mark",
            "middle_name": "I",
            "last_name": "Langdorf",
            "name_suffix": "",
            "institution": "University of California, Irvine, Department of Emergency Medicine, Irvine, CA",
            "department": "None"
        },
        {
            "first_name": "Eric",
            "middle_name": "",
            "last_name": "Wei",
            "name_suffix": "",
            "institution": "University of Michigan, Ann Arbor, MI",
            "department": "None"
        },
        {
            "first_name": "Ali",
            "middle_name": "",
            "last_name": "Ghobadi",
            "name_suffix": "",
            "institution": "University of California, Irvine, Department of Emergency Medicine, Irvine, CA",
            "department": "None"
        },
        {
            "first_name": "Scott",
            "middle_name": "E.",
            "last_name": "Rudkin",
            "name_suffix": "",
            "institution": "University of California, Irvine, Department of Emergency Medicine, Irvine, CA",
            "department": "None"
        },
        {
            "first_name": "Shahram",
            "middle_name": "",
            "last_name": "Lotfipour",
            "name_suffix": "",
            "institution": "University of California, Irvine, Department of Emergency Medicine, Irvine, CA",
            "department": "None"
        }
    ],
    "date_submitted": "2009-07-18T07:00:00Z",
    "date_accepted": "2009-07-18T07:00:00Z",
    "date_published": "2010-09-24T07:00:00Z",
    "render_galley": null,
    "galleys": [
        {
            "label": "",
            "type": "pdf",
            "path": "https://journalpub.escholarship.org/westjem/article/17657/galley/9015/download/"
        }
    ]
}