"… the issue of false-positive catheterization laboratory activation remains a significant concern because unnecessary emergency coronary angiography is not without risk to the patient and may impose a burden on limited human and physical catheterization laboratory resources," the authors write. "This critical decision process must balance the risk of a false alarm with the consequences of delaying myocardial reperfusion."
Guidelines recommend that the emergency department physician make the decision regarding reperfusion therapy, such as coronary angiography, within 10 minutes of interpreting the initial diagnostic electrocardiogram (ECG), which may be challenging because clinical decisions are often made without a previous ECG result for comparison or time to observe ST-segment changes or cardiac biomarker results. A variety of other serious conditions aside from a heart attack may also cause ST-segment elevation. The researchers add that although rapid reperfusion is important, the potential clinical and financial consequences associated with "false alarms" need to be considered.
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