Assessment of prehospital chest pain using telecardiology.
Two hundred general practitioners were equipped with a portable electrocardiograph which could transmit a 12-lead electrocardiogram (ECG) via a telephone line. A cardiologist was available 24 h a day for an interactive teleconsultation. In a 13-month period there were 5073 calls to the telecardiology service and 952 subjects with chest pain were identified. The telecardiology service allowed the general practitioners to manage 700 cases (74%) themselves; further diagnostic tests were requested for 162 patients (17%) and 83 patients (9%) were sent to the hospital emergency department. In the last group a cardiological diagnosis was confirmed in 60 patients and refuted in 23. Seven patients in whom the telecardiology service failed to detect a cardiac problem were hospitalized in the subsequent 48 h. The telecardiology service showed a sensitivity of 97.4%, a specificity of 89.5% and a diagnostic accuracy of 86.9% for chest pain. Telemedicine could be a useful tool in the diagnosis of chest pain in primary care.
Scalvini
Simonetta
S
Fondazione S Maugeri, IRCCS, Department of Cardiology, Gussago, Italy. sscalvini@fsm.it
Zanelli
Emanuela
E
Conti
Claudia
C
Volterrani
Maurizio
M
Pollina
Riccardo
R
Giordano
Amerigo
A
Glisenti
Fulvio
F
D002637:Chest Pain / Q000175:diagnosis*; D004562:Electrocardiography / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care / Q000379:methods; D019114:Remote Consultation / Q000592:standards*; D012680:Sensitivity and Specificity