.ACCinTouch has released an Expert Consensus Decision Pathway on the evaluation and disposition of acute chestpain in the ED. EmergencyMedicine MedTwitter
The American College of Cardiology has released an Expert Consensus Decision Pathway on the evaluation and disposition of acute chest pain in the emergency department .
At the institution level, this decision pathway recommends high-sensitivity cardiac troponin assays coupled with a clinical decision pathway to reduce ED"dwell" times and increase the number of patients with chest pain who can safely be discharged without additional testing. This will decrease ED crowding and limit unnecessary testing, they point out.
When the ECG shows evidence of acute infarction or ischemia, subsequent care should follow current guidelines for management of acute ST-segment elevationPatients with a nonischemic ECG can enter an accelerated CDP designed to provide rapid risk assessment and exclusion of ACS.heart failureHigh-sensitivity cardiac troponin T and high-sensitivity cardiac troponin I are the preferred biomarkers for evaluation of possible ACS.
High-risk patients should usually be admitted to an inpatient setting for further evaluation and treatment.
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