title: Is Telemetry Monitoring Useful in Patients Admitted With Suspected Acute Coronary Syndrome?
abstract: Patients with a chief complaint of chest pain are frequently monitored by telemetry for evaluation of acute coronary syndrome (ACS). However, there is insufficient evidence to support this practice in younger patients without coronary artery disease (CAD). The objective is to assess outcomes of patients younger than 50 years of age and monitored by telemetry. Consecutive medical records of patients admitted for chest pain between January 1, 2009, and June 30, 2010, were reviewed. Patients were excluded who had a CAD history, an abnormal initial troponin, or an abnormal initial electrocardiogram. The remaining patients' charts were evaluated for adverse events such as death, dysrhythmias, ST-elevation myocardial infarction, or upgrade to a higher level of care. Ultimately, 814 patients were selected for study. No study participants suffered a significant adverse event. When being evaluated for ACS, patients younger than 50 without a history of CAD may not benefit from telemetry monitoring.
authors.affiliation: 1 Virginia Tech Carilion School of Medicine, Roanoke, VA.
authors.forename: Jack
authors.initials: J
authors.lastname: Perkins
authors.affiliation: 2 Medstar Franklin Square Medical Center, Baltimore, MD.
authors.forename: Naveen K
authors.initials: NK
authors.lastname: Voore
authors.affiliation: 3 Virginia Commonwealth University Medical Center, Richmond, VA.|4 Johns Hopkins Ciccarone Center for Prevention of Heart Disease, Baltimore, MD.
authors.forename: Jaideep
authors.initials: J
authors.lastname: Patel
authors.affiliation: 2 Medstar Franklin Square Medical Center, Baltimore, MD.|5 University of Maryland Medical Center, Baltimore, MD.
authors.forename: Sathish
authors.initials: S
authors.lastname: Sanna
authors.affiliation: 2 Medstar Franklin Square Medical Center, Baltimore, MD.
authors.forename: Edana
authors.initials: E
authors.lastname: Mann
authors.affiliation: 6 Johns Hopkins University School of Medicine, Baltimore, MD.
authors.forename: Sammy
authors.initials: S
authors.lastname: Zakaria
authors.affiliation: 2 Medstar Franklin Square Medical Center, Baltimore, MD.
authors.forename: Aysegul
authors.initials: A
authors.lastname: Gozu
mesh_terms: D054058:Acute Coronary Syndrome / Q000175:diagnosis*; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D015716:Electrocardiography, Ambulatory / Q000379:methods / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018670:Monitoring, Ambulatory / Q000379:methods / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012307:Risk Factors; D012959:Socioeconomic Factors; D055815:Young Adult
keywords: acute coronary syndrome; chest pain; health care cost; telemetry