Sensitivity of routine clinical criteria for diagnosing myocardial infarction within 24 hours of hospitalization.

Abstract:

:Myocardial infarction was diagnosed in 431 (30%) of 1460 patients with acute chest pain who had serial enzyme testing after admission to intensive or intermediate care units at three teaching and three community hospitals. The diagnosis was made within 12 hours of admission in 331 (77%) patients and within 24 hours in 415 (96%). Of the 16 patients with myocardial infarction who did not have enzyme abnormalities within 24 hours, 9 (56%) had recurrent ischemic pain during this 24-hour period. Of 451 patients who had neither enzyme abnormalities nor recurrent ischemic pain in the first 24 hours, only 7 (2%) ultimately met diagnostic criteria for myocardial infarction. These findings were prospectively validated in an independent testing set of 275 patients with myocardial infarction, 271 (99%) of whom either met diagnostic criteria for myocardial infarction or had recurrent ischemic pain within 24 hours of admission. These data suggest that 24 hours is nearly always a sufficient period to exclude myocardial infarction in patients without recurrent chest pain.

journal_name

Ann Intern Med

authors

Lee TH,Rouan GW,Weisberg MC,Brand DA,Cook EF,Acampora D,Goldman L

doi

10.7326/0003-4819-106-2-181

subject

Has Abstract

pub_date

1987-02-01 00:00:00

pages

181-6

issue

2

eissn

0003-4819

issn

1539-3704

journal_volume

106

pub_type

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