In this observational cohort of almost 400 ED patients presenting with chest pain and a normal EKG, 33% had chest pain during the EKG, and 67% did not. ACS was diagnosed in 17% (defined as +troponin, +stress test, or >70% stenosis on cath), with similar proportions coming from those with chest pain (16%) and those without chest pain (20%) during initial normal EKG. There is little reassurance for a normal EKG with chest pain, in excluding ACS (abstract).
Dr. Scheurer is a clinical hospitalist and the Medical Director of Quality and Safety at the Medical University of South Carolina in Charleston, South Carolina, and is Assistant Professor of Medicine. She is a graduate of the University of Tennessee College of Medicine, completed her residency at Duke University, and completed her Masters in Clinical Research at the Medical University of South Carolina. She also serves as the Web Editor and Physician Advisor for the Society of Hospital Medicine.