Identification of Acute Cardiac Ischemia in the Emergency Department

  • Harry P. Selker
  • Robert J. Zalenski
Part of the Developments in Cardiovascular Medicine book series (DICM, volume 193)


Chest pain and other symptoms suggestive of acute cardiac ischemia (ACI, including acute myocardial infarction [AMI] and unstable angina pectoris) account for over 6 million emergency department (ED) visits per year. Of these, the approximately 30% who truly have ACI (just under half of whom will prove to have AMI) [1] must be quickly and accurately separated from the majority of ED patients who do not have ACI and then promptly treated and admitted to the hospital. This is not an easy task, the environment in which this must be done is not often optimal, and there are no perfect tests that completely handle all possible cases. However, as reviewed in this chapter, there are a number of tests and strategies, that, when combined with good clinical judgement, can be of significant assistance.


Chest Pain Acute Myocardial Infarction Myocardial Blood Flow Emergency Department Physician Emergency Department Setting 


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© Kluwer Academic Publishers 1997

Authors and Affiliations

  • Harry P. Selker
  • Robert J. Zalenski

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