| Original language | English (US) |
|---|---|
| Pages (from-to) | 1925-1960 |
| Number of pages | 36 |
| Journal | Journal of the American College of Cardiology |
| Volume | 80 |
| Issue number | 20 |
| DOIs | |
| State | Published - Nov 15 2022 |
Keywords
- ACC Expert Consensus Decision Pathway
- accelerated diagnostic pathway
- acute coronary syndrome
- biomarkers
- cardiac imaging
- chest pain
- clinical decision pathway
- emergency department
- myocardial infarction
- myocardial injury
- myocardial ischemia
- stress test
- troponins
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
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In: Journal of the American College of Cardiology, Vol. 80, No. 20, 15.11.2022, p. 1925-1960.
Research output: Contribution to journal › Article › peer-review
}
TY - JOUR
T1 - 2022 ACC Expert Consensus Decision Pathway on the Evaluation and Disposition of Acute Chest Pain in the Emergency Department
T2 - A Report of the American College of Cardiology Solution Set Oversight Committee
AU - Kontos, Michael C.
AU - de Lemos, James A.
AU - Deitelzweig, Steven B.
AU - Diercks, Deborah B.
AU - Gore, M. Odette
AU - Hess, Erik P.
AU - McCarthy, Cian P.
AU - McCord, James K.
AU - Musey, Paul I.
AU - Villines, Todd C.
AU - Wright, Leesa J.
N1 - Funding Information: This Expert Consensus Decision Pathway is designed to parallel the usual course of evaluation of patients in the ED with symptoms requiring evaluation for possible ACS (see Figure 1). The first step is careful evaluation of the ECG (see Section 5.2). Patients with a nonischemic ECG can enter an accelerated CDP designed to provide rapid risk assessment and exclusion of ACS (see Section 5.4). Patients classified as low risk (rule out) using hs-cTn–based CDPs supported by this document can generally be discharged directly from the ED without additional testing, although outpatient testing may be considered in selected cases. In contrast, patients with substantially elevated initial hs-cTn values or those who have significant dynamic changes over 1 to 3 hours are assigned to the abnormal/high-risk category and should be further classified according to the Universal Definition of MI into type 1 or 2 MI or acute or chronic nonischemic cardiac injury (see Section 5.7). High-risk patients should usually be admitted to an inpatient setting for further evaluation and treatment. Patients determined to be intermediate risk with the CDP should undergo additional observation with repeat hs-cTn measurements at 3 to 6 hours and risk assessment using either the modified History, ECG, Age, Risk Factors, and Troponin (HEART) score or the ED Assessment of Chest Pain Score (EDACS) (see Section 5.5). Noninvasive testing should be considered for the intermediate-risk group unless low-risk features are identified using risk scores or noninvasive testing has been performed recently with normal or low-risk findings. Details of the assessment steps are provided in Section 5.
PY - 2022/11/15
Y1 - 2022/11/15
KW - ACC Expert Consensus Decision Pathway
KW - accelerated diagnostic pathway
KW - acute coronary syndrome
KW - biomarkers
KW - cardiac imaging
KW - chest pain
KW - clinical decision pathway
KW - emergency department
KW - myocardial infarction
KW - myocardial injury
KW - myocardial ischemia
KW - stress test
KW - troponins
UR - http://www.scopus.com/inward/record.url?scp=85140947122&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85140947122&partnerID=8YFLogxK
U2 - 10.1016/j.jacc.2022.08.750
DO - 10.1016/j.jacc.2022.08.750
M3 - Article
C2 - 36241466
AN - SCOPUS:85140947122
SN - 0735-1097
VL - 80
SP - 1925
EP - 1960
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
IS - 20
ER -