outcomes were defined as AMI, PCI, cardiac death, 70% stenosis in a major coronary artery and changes in a patient’s nuclear stress test. Steele, R., McNaughton, T., The purpose of this This is a prospective 270 patients Weaknesses: 1.) The McConahy, M., & Lam, J. study is to evaluate the observational cohort participated in the excluded patients (2006).Chest pain in use of nitroglycerin as study was conducted study. Of those 270 who had a low risk for emergency department a diagnostic test for over a 9 month period patients, 66% had their cardiac issues. 2.) The patients: If the pain is determining whether a of time. The study took chest pain relieved by study took place over a relieved by nitroglycerin, is patient’s chest pain is place in an urban nitroglycerin. Patients 9-month period. 3.) it more likely to be cardiac cardiac or non-cardiac. emergency room were followed up with The study involved chest pain? affiliated with an via telephone 4 weeks only a small patient CJEM: The academic institution. after being in the ED. population. 4.) The Journal of the Canadian 257 patients ECG was read only by Association of Emergency 164-169. Outcome Measures: participated in follow- the ED physician. Physicians, 8(3), Patients initial chest up phone calls. Patients of Evidence: pain score was recorded received nitroglycerin Strengths: 1.) The and subsequently after based on their study used the TIMI Level IV each dose of presentation at triage of score to classify nitroglycerin. The pain chest pain. It was patients. 2.) The scale used was 1-10 and determined through this patient’s relief from the visual analog score study that chest pain nitroglycerin was with happy to sad faces. relief through measured within 5 nitroglycerin dosing minutes of receiving may not be a reliable the medication. 3.) The determining factor of study determined that whether a patient’s chest pain relief from chest pain is cardiac nitro is ambivalent to related or not. There whether the patient is were 177 patients who
outcomes were defined as AMI, PCI, cardiac death, 70% stenosis in a major coronary artery and changes in a patient’s nuclear stress test. Steele, R., McNaughton, T., McConahy, M., & Lam, J. (2006).Chest pain in emergency department patients: If the pain is relieved by nitroglycerin, is it more likely to be cardiac chest pain? CJEM: The Journal of the Canadian Association of Emergency Physicians, 8(3), 164-169. of Evidence: Level IV The purpose of this study is to evaluate the use of nitroglycerin as a diagnostic test for determining whether a patient’s chest pain is cardiac or non-cardiac. This is a prospective observational cohort study was conducted over a 9 month period of time. The study took place in an urban emergency room affiliated with an academic institution. Outcome Measures: Patients initial chest pain score was recorded and subsequently after each dose of nitroglycerin. The pain scale used was 1-10 and the visual analog score with happy to sad faces. 270 patients participated in the study. Of those 270 patients, 66% had their chest pain relieved by nitroglycerin. Patients were followed up with via telephone 4 weeks after being in the ED. 257 patients participated in follow- up phone calls. Patients received nitroglycerin based on their presentation at triage of chest pain. It was determined through this study that chest pain relief through nitroglycerin dosing may not be a reliable determining factor of whether a patient’s chest pain is cardiac related or not. There were 177 patients who Weaknesses: 1.) The excluded patients who had a low risk for cardiac issues. 2.) The study took place over a 9-month period. 3.) The study involved only a small patient population. 4.) The ECG was read only by the ED physician. Strengths: 1.) The study used the TIMI score to classify patients. 2.) The patient’s relief from nitroglycerin was measured within 5 minutes of receiving the medication. 3.) The study determined that chest pain relief from nitro is ambivalent to whether the patient is
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