Henneman PL, Mena IG, Rothstein RJ, Garrett KB, Pleyto AS, French WJ. Evaluation of patients with chest pain and nondiagnostic ECG using thallium-201 myocardial planar imaging and technetium-99m first-pass radionuclide angiography in the emergency department.
Ann Emerg Med 1992;
21:545-50. [PMID:
1570911 DOI:
10.1016/s0196-0644(05)82522-3]
[Citation(s) in RCA: 22] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
STUDY OBJECTIVE
The purpose of this study was to determine if thallium-201 myocardial planar imaging and technetium-99m first-pass radionuclide angiography, performed in the emergency department, could predict which patients with acute chest pain and nondiagnostic ECGs were more likely to have an acute myocardial infarction (AMI).
DESIGN
Retrospective analysis.
SETTING
Urban, county ED.
TYPE OF PARTICIPANTS
Convenience sample of 47 patients with acute chest pain suggestive of myocardial ischemia and nondiagnostic ECG.
INTERVENTIONS
Thallium-201 myocardial imaging and technetium-99m first-pass radionuclide angiography in the ED.
MEASUREMENTS AND MAIN RESULTS
Four patients had an AMI (ie, CK-MB greater than or equal to 6% total CK). The combined scans had a sensitivity of 75%, (95% confidence interval [Cl], 19-99%), a specificity of 42% (95% CI, 27-58%), an accuracy of 45% (95% CI, 19-99%), a positive predictive value of 11% (95% CI, 2-29%), and a negative predictive value of 95% (95% CI, 75-100%) in predicting AMI.
CONCLUSION
Thallium-201 myocardial planar imaging and technetium-99m first-pass radionuclide angiography performed in the ED do not appear to be useful in determining which patients with acute chest pain and nondiagnostic ECG are likely to have an AMI.
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