title: Dobutamine Stress Tele-Echocardiography as a Clinical Service in the Emergency Department to Evaluate Patients With Chest Pain.
abstract: Patients presenting with chest pain to the emergency department should be efficiently triaged. During our previous research trial, the use of dobutamine stress tele-echocardiography (DSTE) effectively and safely allowed the diagnosis of patients who could be released from the emergency department. To assess the usefulness of DSTE as a clinical service, the protocols, training, and implementation of our experience are reviewed from > 4 years of testing 734 patients in our emergency department. The patient demographics of those tested appeared to remain consistent during the study period. An average of 12.5% of patients who underwent DSTE yielded abnormal results. In addition to myocardial ischemia, numerous cardiac disorders were uncovered. Side effects from DSTE caused the testing to be prematurely discontinued in 3.1% of patients. Within approximately 6 hours of arrival at the emergency department, 70% were discharged after their normal DSTE. DSTE appears to be safe, rapid, and useful in triaging nonstudy patients with chest pain who are of low to moderate risk for myocardial infarction or ischemia.
authors.affiliation: MPC II, Suite 300, 1801 North Senate Avenue, Indianapolis, IN 46202.
authors.forename: James A.
authors.initials: JA
authors.lastname: Trippi
authors.forename: Kamthorn S.
authors.initials: KS
authors.lastname: Lee