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Letters |15 August 1995

Evaluation of Chest Pain in the Emergency Department

Tsung O. Chen

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TO THE EDITOR:
I read with interest the editorial by Kaul and Abbott [1] on evaluation of chest pain in the emergency department. Although the authors made several valuable recommendations on the assessment of acute chest pain in patients in the emergency department, they did not mention one simple and important aid in the decision-making process—the availability of a previously obtained electrocardiogram.
If a patient with chest pain comes to the emergency department and has abnormal electrocardiographic findings (for example, Q waves, ST-segment changes, left bundle-branch block, premature ventricular contractions, or atrial fibrillation), no physician can determine from one isolated electrocardiogram whether the abnormalities are old or new. Therefore, these patients are generally admitted for observation until serial electrocardiograms determine whether these changes are preexistent. Today, with the availability of facsimile machines in every hospital, it is easy to contact the patient's primary physician or the record department of the patient's hospital, especially during the weekend or the evening, to secure a copy of the previous electrocardiogram for comparison.
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Chen TO. Evaluation of Chest Pain in the Emergency Department. Ann Intern Med. 1995;123:314–318. doi: 10.7326/0003-4819-123-4-199508150-00019

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Published: Ann Intern Med. 1995;123(4):314-318.

DOI: 10.7326/0003-4819-123-4-199508150-00019

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