Clinical policy: Critical issues in the evaluation and management of adult patients presenting with suspected acute myocardial infarction or unstable angina

F. M. Fesmire, M. Campbell, W. W. Decker, J. M. Howell, Jeffrey Kline, S. V. Cantrill, S. A. Colucciello, W. C. Dalsey, W. W. Decker, F. M. Fesmire, J. M. Howell, A. S. Jagoda, Jr Karas S., E. K. Kuffner, T. W. Lukens, P. J. Mariani, D. L. Morgan, B. A. Murphy, M. P. Pietrzak, S. M. SilversS. Wall, R. L. Wears, G. W. Molzen, R. Whitson

Research output: Contribution to journalArticle

70 Citations (Scopus)

Abstract

This clinical policy focuses on critical issues in the evaluation and management of patients with acute myocardial infarction or unstable angina. A MEDLINE search for articles published between January 1993 and December 1998 was performed using combinations of the key words chest pain, acute myocardial infarction, unstable angina, thrombolytics, primary angioplasty, 12-lead ECG, ST-segment monitoring, cardiac serum markers, and chest pain centers. Subcommittee members and expert peer reviewers also supplied articles with direct bearing on the policy. This policy focuses on 5 areas of current interest and/or controversy: (1) ECG eligibility criteria for fibrinolytic therapy, (2) role of primary angioplasty in patients with acute myocardial infarction, (3) use of serum markers to diagnose acute myocardial infarction, (4) serial 12-lead ECGs during the initial evaluation, and (5) chest pain evaluation units. Recommendations for patient management are provided for each of these 5 topics based on strength of evidence (Standards, Guidelines, Options). Standards represent patient management principles that reflect a high degree of clinical certainty; Guidelines represent patient management principles that reflect moderate clinical certainty; and Options represent other patient management strategies based on preliminary, inconclusive, or conflicting evidence, or based on panel consensus. This guideline is intended for physicians working in hospital-based emergency departments or chest pain evaluation units.

Original languageEnglish
Pages (from-to)521-544
Number of pages24
JournalAnnals of Emergency Medicine
Volume35
Issue number5
StatePublished - 2000
Externally publishedYes

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Unstable Angina
Myocardial Infarction
Chest Pain
Electrocardiography
Guidelines
Angioplasty
Biomarkers
Pain Clinics
Thrombolytic Therapy
MEDLINE
Hospital Emergency Service
Physicians

ASJC Scopus subject areas

  • Emergency Medicine

Cite this

Clinical policy : Critical issues in the evaluation and management of adult patients presenting with suspected acute myocardial infarction or unstable angina. / Fesmire, F. M.; Campbell, M.; Decker, W. W.; Howell, J. M.; Kline, Jeffrey; Cantrill, S. V.; Colucciello, S. A.; Dalsey, W. C.; Decker, W. W.; Fesmire, F. M.; Howell, J. M.; Jagoda, A. S.; Karas S., Jr; Kuffner, E. K.; Lukens, T. W.; Mariani, P. J.; Morgan, D. L.; Murphy, B. A.; Pietrzak, M. P.; Silvers, S. M.; Wall, S.; Wears, R. L.; Molzen, G. W.; Whitson, R.

In: Annals of Emergency Medicine, Vol. 35, No. 5, 2000, p. 521-544.

Research output: Contribution to journalArticle

Fesmire, FM, Campbell, M, Decker, WW, Howell, JM, Kline, J, Cantrill, SV, Colucciello, SA, Dalsey, WC, Decker, WW, Fesmire, FM, Howell, JM, Jagoda, AS, Karas S., J, Kuffner, EK, Lukens, TW, Mariani, PJ, Morgan, DL, Murphy, BA, Pietrzak, MP, Silvers, SM, Wall, S, Wears, RL, Molzen, GW & Whitson, R 2000, 'Clinical policy: Critical issues in the evaluation and management of adult patients presenting with suspected acute myocardial infarction or unstable angina', Annals of Emergency Medicine, vol. 35, no. 5, pp. 521-544.
Fesmire, F. M. ; Campbell, M. ; Decker, W. W. ; Howell, J. M. ; Kline, Jeffrey ; Cantrill, S. V. ; Colucciello, S. A. ; Dalsey, W. C. ; Decker, W. W. ; Fesmire, F. M. ; Howell, J. M. ; Jagoda, A. S. ; Karas S., Jr ; Kuffner, E. K. ; Lukens, T. W. ; Mariani, P. J. ; Morgan, D. L. ; Murphy, B. A. ; Pietrzak, M. P. ; Silvers, S. M. ; Wall, S. ; Wears, R. L. ; Molzen, G. W. ; Whitson, R. / Clinical policy : Critical issues in the evaluation and management of adult patients presenting with suspected acute myocardial infarction or unstable angina. In: Annals of Emergency Medicine. 2000 ; Vol. 35, No. 5. pp. 521-544.
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AU - Howell, J. M.

AU - Kline, Jeffrey

AU - Cantrill, S. V.

AU - Colucciello, S. A.

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AU - Fesmire, F. M.

AU - Howell, J. M.

AU - Jagoda, A. S.

AU - Karas S., Jr

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AU - Lukens, T. W.

AU - Mariani, P. J.

AU - Morgan, D. L.

AU - Murphy, B. A.

AU - Pietrzak, M. P.

AU - Silvers, S. M.

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AU - Wears, R. L.

AU - Molzen, G. W.

AU - Whitson, R.

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