title: Assessment of prehospital chest pain using telecardiology.
abstract: 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.
authors.affiliation: Fondazione S Maugeri, IRCCS, Department of Cardiology, Gussago, Italy. sscalvini@fsm.it
authors.forename: Simonetta
authors.initials: S
authors.lastname: Scalvini
authors.forename: Emanuela
authors.initials: E
authors.lastname: Zanelli
authors.forename: Claudia
authors.initials: C
authors.lastname: Conti
authors.forename: Maurizio
authors.initials: M
authors.lastname: Volterrani
authors.forename: Riccardo
authors.initials: R
authors.lastname: Pollina
authors.forename: Amerigo
authors.initials: A
authors.lastname: Giordano
authors.forename: Fulvio
authors.initials: F
authors.lastname: Glisenti
mesh_terms: 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