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Raymond J. Gibbons, MD

JAMA. 2002;288:2745-2746.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

More than 6 million patients in the United States present to emergency departments (EDs) each year with chest pain or other symptoms suggestive of myocardial ischemia.¹ The challenge for the family practitioner, general internist, emergency physician, or cardiologist is to rapidly evaluate such patients and to accurately identify those at highest risk, thereby appropriately using hospitalization and urgent therapy, while expeditiously discharging those who do not require hospitalization. The principal tools currently available to physicians are the clinical history, acute electrocardiogram, and measurement of biochemical cardiac markers.

Other strategies, such as acute myocardial imaging and stress testing, represent alternative potential approaches. Myocardial perfusion imaging was first studied in the evaluation of acute chest pain more than 20 years ago,² and in one center has been successfully incorporated into a comprehensive strategy for the evaluation and triage of patients with chest pain.³ However, myocardial imaging has not . . . [Full Text of this Article]

Author Affiliation: Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, Rochester, Minn.

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