Identifying Acute Cardiac Ischemia in the Emergency Department

  • J. Hector Pope
  • Harry P. Selker
Part of the Contemporary Cardiology book series (CONCARD)


Accurate identification of acute cardiac ischemia (ACI) in the emergency department (ED) remains a task that challenges the skill of the most seasoned clinician, even though angina pectoris was described in great detail more than 200 years ago by Heberden (1) and the presentation of acute myocardial infarction (AMI) was first reported 85 years ago by Herrick (2). Each year in the United States, over 6 million patients with chest pain or Imminent Myocardial Infarction Rotterdam (IMIR) Study (3) inclusion symptoms present to EDs (4), and approximately 25% of these will have ACI. Physicians have the task of identifying, treating, and hospitalizing (in the appropriate unit) the approximately one-third of these patients who have true ACI (5) (i.e., either AMI or unstable angina pectoris [UAP]), to avoid filling hospital telemetry, stepdown units, and coronary care units with the large majority of patients who do not have ACI.


Chest Pain Acute Myocardial Infarction Acute Myocardial Infarction Final Diagnosis Chief Complaint 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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© Springer Science+Business Media New York 1999

Authors and Affiliations

  • J. Hector Pope
  • Harry P. Selker

There are no affiliations available

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