Outcome in suspected acute myocardial infarction with normal or minimally abnormal admission electrocardiographic findings.


Journal Article

Seven hundred seventy-five consecutive patients with symptoms suggestive of acute myocardial infarction (AMI) who were admitted to the cardiac care unit from the emergency room were studied; 107 had normal electrocardiographic findings and 73 had only minimal nonspecific changes. AMI subsequently evolved in 11 patients (10%) with normal electrocardiographic findings and in 6 (8%) with minimal changes, compared with 245 (41%) with frankly abnormal emergency room findings. Only 1 (1%; 95% confidence limits 0.02 to 5%) and 4 (6%; 95% confidence limits 2 to 15%) of those with normal and nonspecific initial electrocardiographic findings, respectively, had a complication for which they potentially benefited from intensive care unit intervention, although many patients received prophylactic therapy. Thus, the initial emergency room electrocardiogram can effectively separate patients into high- and low-risk groups for AMI and serious complications. Admission to a monitored intermediate care ward may be an acceptable practice in patients with chest pain and a normal or minimally changed initial electrocardiogram.

Full Text

Duke Authors

Cited Authors

  • Slater, DK; Hlatky, MA; Mark, DB; Harrell, FE; Pryor, DB; Califf, RM

Published Date

  • October 1, 1987

Published In

Volume / Issue

  • 60 / 10

Start / End Page

  • 766 - 770

PubMed ID

  • 3661390

Pubmed Central ID

  • 3661390

International Standard Serial Number (ISSN)

  • 0002-9149

Digital Object Identifier (DOI)

  • 10.1016/0002-9149(87)91020-4


  • eng

Conference Location

  • United States