Uncertainty and delay are common in the diagnosis of acute coronary syndromes (ACS).
In the last 20 years, the need for faster, more accurate, and more cost-effective diagnosis gave rise to the concept of specialized treatment of patients with chest pain in emergency departments (EDs).
The original strategy dedicated a separate section of the ED and a nursing staff to the task of rapid intervention in patients with acute myocardial infarction (MI) and triage of low-risk patients.
Chest pain centers grew quickly in popularity but evolved with a variety of goals, staffing plans, diagnostic resources, and levels of commitment.
Three existing centers-the University of Cincinnati Heart ER, Brigham and Women's Hospital, and the Medical College of Virginia-have implemented chest pain strategies with the common aims of (1) screening for the entire spectrum of coronary artery disease, (2) avoiding unnecessary admissions, and (3) using multiple diagnostic modalities.
Yet, they differ in the specifics of their approaches and diagnostic methods (e.g., echocardiography vs. treadmill vs. myocardial perfusion imaging).
The safety and cost effectiveness of these centers are discussed.
Mots-clés Pascal : Infarctus, Myocarde, Aigu, Douleur, Thorax, Service urgence, Analyse coût, Economie santé, Diagnostic, Traitement, Homme, Appareil circulatoire pathologie, Cardiopathie coronaire, Myocarde pathologie
Mots-clés Pascal anglais : Infarct, Myocardium, Acute, Pain, Thorax, Emergency department, Cost analysis, Health economy, Diagnosis, Treatment, Human, Cardiovascular disease, Coronary heart disease, Myocardial disease
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0431186
Code Inist : 002B12A03. Création : 22/03/2000.