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Acute coronary syndrome

Prevalence
Clinical features
Differential diagnosis
Investigations
Therapy
Prevention
Prognosis
Investigations

Arrange stress testing on discharge or as an outpatient using any of  a
  • single-photon emission computed tomography) a  

Why?

An abnormal exercise SPECT makes coronary artery disease more likely

Patient Target Disorder and
Reference Standard		 Diagnostic Test LR+
(95% CI) 		Post-test Probability LR-
(95% CI) 		Post-test Probability
suspected coronary artery disease a
(pre-test probability: 76%) 		coronary artery disease
(coronary angiography) 		exercise SPECT 2.2
(2.0 to 2.4) 		87% 0.18
(0.16 to 0.20) 		36%
 

Note:

  • There is little difference in the cost-effectiveness of angiography, PET (positron emission tomography), SPECT, echocardiography or thallium scanning. a
 

 

Expiry date: June 2003
Levels of Evidence used in grading these guides

Authors   CM   Ball , N   Shenker
Reviewer   I K   Jang
CAT Writers   N   Shenker , CJ   Wotton , CM   Ball , RS   Phillips