Comparison of Early Dobutamine Stress Echocardiography and Exercise Electrocardiographic Testing for Management of Patients Presenting to the Emergency Department With Chest Pain

Uso da cintilografia miocárdica em repouso durante dor torácica para descartar infarto agudo do miocárdio

“…The admission of patients to undergo an investigative route generates costs to both the hospital and health insurance companies, which can have negative impacts on the health system. There is evidence corroborating the costbenefit of the injection protocol for chest pain 6 . Resting MPS after chest pain also has an important prognostic value as most patients remain without any events for up to one month 6 .…”

“…At the emergency room, conventional evaluation of the chest pain patient consists of history taking, physical examination, electrocardiogram and measurements of myocardial necrosis markers 6 . Despite being accurate, this approach delays the discharge of low-risk patients until the measurements of necrosis markers dismiss the presence of myocardial injury.…”

“…Findings showing perfusion defects associated or not with abnormal motility and/or wall thickness were considered positive. All other findings were considered negative 6 . Patients with previous infarction were not excluded as they represented a significant portion of patients presenting with chest pain and nondiagnostic ECG, which means that, at admission, this population consisted of low-and mediumrisk patients.…”

“…Stress echocardiography and cardiac magnetic resonance are tools with sensitivity similar to that of myocardial scintigraphy; however, whereas the former is an operatordependent technique that demands an adequate acoustic window, claustrophobia, use of pacemakers and metal prostheses, as well as a relative lack of studies, are limitations that preclude the use of the latter 6,7 .…”

Kurzdarstellung

“…Nichtinvasive Techniken wie CT-Angiographie [779], kardiale Magnetresonanztomographie, myokardiale Perfusionsszintigraphie [780] und Echokardiographie [781] wurden als Möglichkeiten evaluiert, die Niedrigrisikogruppen zu untersuchen und Subgruppen zu identifizieren, die sicher nach Hause entlassen werden kön-nen [782][783][784][785].…”