[Chest pain similar to angina. Identification of patients at risk of developing acute coronary failure].
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.(ABSTRACT TRUNCATED AT 250 WORDS)
Sardella
F
F
Divisione di Medicina d'Urgenza, Ospedale Maggiore di Milano.
Checchini
M
M
Pierini
A
A
Riglietti
G F
GF
Fenaroli
F
F
Negrini
M
M
Serpico
S
S
Rovey
R
R
Omboni
E
E
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000787:Angina Pectoris / Q000175:diagnosis*; D000789:Angina, Unstable / Q000209:etiology; D002637:Chest Pain / Q000150:complications* / Q000175:diagnosis*; D003937:Diagnosis, Differential; D004562:Electrocardiography; D004630:Emergencies; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology; D017202:Myocardial Ischemia / Q000209:etiology*; D011379:Prognosis; D012307:Risk Factors