Ischemic heart disease in the emergency room: state of the art, innovation and research

Abstract

This opinion paper is aimed to provide an overview about the state of the art, innovation and research in ischemic heart disease in the emergency room, and is a synopsis of the lectures of the 3 rd Italian GREAT Network Congress (Rome, 15-19 October 2012). The leading issues of a multidisciplinary risk stratification and diagnosis of patients presenting to the emergency department with suspected ischemic heart disease will be discussed taking into consideration the variable onset of clinical signs and symptoms, the role of novel highly-sensitive troponin immunoassays, the promising use of an 80-lead electrocardiogram, echocardiography and risk stratification scores. Preliminary information will also be provided about the ongoing Italian multicentric registry on chest pain patients in emergency department, an observational prospective study aimed to collect data about patients presenting at the emergency department with typical chest pain suggesting an acute coronary syndrome.

Biomarker validation in the emergency department. General criteria and clinical implications

“…This challenging paradigm is particularly suited for the topic of this article, since it represents the leading cause of ED admission, and the diagnostic work up is now largely dependent upon results of biomarker testing. 9,10 The data used in this article were obtained in a population of 98 consecutive patients (mean age 67 years, range: 35-84; 67 males and 31 females) admitted to the ED of the Academic Hospital of Parma for suspected AMI over three working days. Blood samples were collected at patient admission in primary blood tubes containing no additives (Becton Dickinson, Franklin Lakes, NJ, USA) and were rapidly transported to the central laboratory, where they were centrifuged at 1300 ¥ g for 10 min at room temperature.…”