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.
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).


METHODS
Retrospective analysis.


METHODS
Urban, county ED.


METHODS
Convenience sample of 47 patients with acute chest pain suggestive of myocardial ischemia and nondiagnostic ECG.


METHODS
Thallium-201 myocardial imaging and technetium-99m first-pass radionuclide angiography in the ED.


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.


CONCLUSIONS
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.
Henneman
P L
PL
Department of Emergency Medicine, Harbor-UCLA Medical Center, Torrance.
Mena
I G
IG
Rothstein
R J
RJ
Garrett
K B
KB
Pleyto
A S
AS
French
W J
WJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002637:Chest Pain / Q000175:diagnosis*; D016001:Confidence Intervals; D004562:Electrocardiography; D005188:False Negative Reactions; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000000981:diagnostic imaging*; D010865:Pilot Projects; D011237:Predictive Value of Tests; D011875:Radionuclide Angiography; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013794:Thallium Radioisotopes
D013794:Thallium Radioisotopes