Document Detail

Exercise testing in chest pain units: rationale, implementation, and results.
MedLine Citation:
PMID:  16278120     Owner:  NLM     Status:  MEDLINE    
Chest pain units are now established centers for assessment of low-risk patients presenting to the emergency department with symptoms suggestive of acute coronary syndrome. Accelerated diagnostic protocols, of which treadmill testing is a key component, have been developed within these units for efficient evaluation of these patients. Studies of the last decade have established the utility of early exercise testing,which has been safe, accurate, and cost-effective in this setting. Specific diagnostic protocols vary, but most require 6 to 12 hours of observation by serial electrocardiography and cardiac injury markers to exclude infarction and high-risk unstable angina before proceeding to exercise testing. However, in the chest pain unit at UC Davis Medical Center,the approach includes "immediate" treadmill testing without a traditional process to rule out myocardial infarction. Extensive experience has validated this approach in a large, heterogeneous population. The optimal strategy for evaluating low-risk patients presenting to the emergency department with chest pain will continue to evolve based on current research and the development of new methods.
Ezra A Amsterdam; J Douglas Kirk; Deborah B Diercks; William R Lewis; Samuel D Turnipseed
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Cardiology clinics     Volume:  23     ISSN:  0733-8651     ISO Abbreviation:  Cardiol Clin     Publication Date:  2005 Nov 
Date Detail:
Created Date:  2005-11-09     Completed Date:  2006-02-28     Revised Date:  2009-11-03    
Medline Journal Info:
Nlm Unique ID:  8300331     Medline TA:  Cardiol Clin     Country:  United States    
Other Details:
Languages:  eng     Pagination:  503-16, vii     Citation Subset:  IM    
Department of Internal Medicine, University of California School of Medicine (Davis) and Medical Center, Sacramento, CA 95817, USA.
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MeSH Terms
Acute Disease
Angina, Unstable / diagnosis*
Coronary Care Units
Early Diagnosis
Exercise Test*
Myocardial Infarction / diagnosis*
Outcome and Process Assessment (Health Care)
Practice Guidelines as Topic
Risk Assessment

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