title: Emergency nontraumatic chest pain: use of stress echocardiography to detect significant coronary artery stenosis.
abstract: OBJECTIVE
  We sought to assess the usefulness of stress echocardiography in a chest pain department.
  
  
  METHODS
  Consecutive patients (n = 487) with nontraumatic chest pain, with no signs of myocardial ischemia on arrival to the emergency department, 6 and 12 hours later, were recruited.
  
  
  RESULTS
  The sensitivity and specificity of stress echocardiography in the biased sample were 74% (95% confidence interval [CI] 63-85%) and 65% (95% CI 44-86%). After application of the method of Begg and Greenes to debias the sample, the calculated sensitivity was 24% (95% CI 19-29%) and specificity was 94% (95% CI 91-97%). After application of Diamond's method, sensitivity was 32% (95% CI 21-44%) and specificity (normalcy rate) was 99% (95% CI 88-100%).
  
  
  CONCLUSIONS
  Stress echocardiography is an insensitive test when used to detect significant coronary artery stenosis in patients presenting with nontraumatic chest pain with no objective signs of myocardial ischemia.
authors.affiliation: Division of Cardiology, Hospital de León, León, Spain. med016340@saludalia.com
authors.forename: Ignacio
authors.initials: I
authors.lastname: Iglesias-Garriz
authors.forename: Miguel Angel
authors.initials: MA
authors.lastname: Rodríguez
authors.forename: Esteban
authors.initials: E
authors.lastname: García-Porrero
authors.forename: Fernando
authors.initials: F
authors.lastname: Ereño
authors.forename: Carmen
authors.initials: C
authors.lastname: Garrote
authors.forename: Gonzalo
authors.initials: G
authors.lastname: Suarez
mesh_terms: D000368:Aged; D002637:Chest Pain / Q000175:diagnosis* / Q000209:etiology*; D023921:Coronary Stenosis / Q000150:complications* / Q000000981:diagnostic imaging*; D003422:Critical Care / Q000379:methods; D004452:Echocardiography / Q000379:methods*; D004632:Emergency Medical Services / Q000379:methods; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D015203:Reproducibility of Results; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D012680:Sensitivity and Specificity; D014947:Wounds and Injuries / Q000150:complications / Q000175:diagnosis