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Noninvasive Testing in Emergency Department Patients with Low-Risk Chest Pain

Does the Evidence Support Current Guidelines?

Foy, Andrew J. MD; Sciamanna, Christopher MD, MPH; Davidson, William R. MD

doi: 10.1097/CRD.0000000000000096
Review Articles

Patients who present to the emergency department with chest pain but no evidence of ischemia on the electrocardiogram and negative cardiac markers are at very low risk. The newest American Heart Association/American College of Cardiology guidelines give noninvasive cardiac testing a IIa recommendation in this patient population. Here, we will review the existing literature that was cited in the American Heart Association/American College of Cardiology document, as well as several large, contemporary, comparative observational studies which were not included to address the following question: Do the benefits of noninvasive cardiac testing in this patient population outweigh the risks?

From the *Division of Cardiology, Heart and Vascular Institute, Department of Public Health Sciences, Hershey, PA, and Department of Medicine, Penn State Hershey Medical Center, Hershey, PA.

Disclosure: The authors have no conflicts of interest to report.

Correspondence: Andrew J. Foy, MD, 500 University Drive, P.O. Box 850, Hershey, PA 17033. E-mail:

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