Chest pain similar to angina. Identification of patients at risk of developing acute coronary failure
Sardella, F.; Checchini, M.; Pierini, A.; Riglietti, G.F.; Fenaroli, F.; Negrini, M.; Serpico, S.; Rovey, R.; Omboni, E.
Annali Italiani di Medicina Interna Organo Ufficiale Della Societa Italiana di Medicina Interna 10(2): 119-124
1995
ISSN/ISBN: 0393-9340 PMID: 7619651 Document Number: 448898
In order to improve the diagnostic procedure for patients with chest pain suspected of having acute ischemic heart disease we elaborated a mathematical model to predict ischemic risk and then compared its predictive capacity with that of the physician. From September 1989 to December 1992, 564 patients with a chief symptom of chest pain were seen at our Emergency Room (ER). Sixty-two percent of them were male, mean age was 58 +/- 13 years, and none had acute myocardial infarction or unstable angina. Clinical and historical data, serial sampling of enzymes and ECG patterns were collected for 4 hours after admission to the ER. At that point a decision was made to hospitalize or discharge that patient. Follow-up was completed within 2 months. At the end of follow-up, we observed that the physician's assessment resulted in 35% true positive, 55% true negative, 4.7% false positive, and 5.3% false negative judgments for acute ischemic heart disease.