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Use of Echocardiography in the Evaluation of Chest Pain in the Emergency Department

This study is ongoing, but not recruiting participants.
Information provided by (Responsible Party):
New York University School of Medicine Identifier:
First received: May 14, 2010
Last updated: November 10, 2016
Last verified: November 2016

Chest pain is one of the most common complaints that brings a patient to the emergency department (ED). The differential diagnosis of chest pain is broad and includes cardiac as well as non-cardiac diseases. One of the initial goals in the ED evaluation of a patient presenting with chest pain is to rapidly and accurately diagnose the presence or absence of acute coronary syndrome. The diagnostic accuracy of the initial routine evaluation is often limited and results in frequent admissions for patients presenting with chest pain for further diagnostic testing.

Echocardiography has a high sensitivity and specificity for the diagnosis of acute myocardial infarction. Tissue Doppler imaging with strain and strain rate (SR) measurement is a new echocardiographic technique, which enables accurate assessment of regional left ventricular systolic and diastolic function. Prior studies have shown that abnormal strain and SR are highly sensitive markers of ischemia. Acute ischemia induces early systolic thinning and a delay in the onset of systolic thickening, a progressive decrease in the rate and degree of maximal systolic thickening, and an abnormal ischemia-related thickening which occurs after aortic valve closure. A major obstacle to the routine use of echocardiography in the ED is the need for portable studies, using heavy, bulky portable echo machines. There are currently available portable hand-held echo machines (GE-Vivid I) that produce high quality images and offer an opportunity to incorporate echocardiography into routine practice in the ED.

We propose to study the use of early, portable echocardiography, with detailed assessment of wall motion and left ventricular function by strain and strain rate measurements, for the evaluation of chest pain in the ED. We hypothesize that an early with detailed left ventricular function assessment will be highly sensitive and specific for the diagnosis of myocardial ischemia, and will enable rapid triage of patients who present to the ED with chest pain.

Condition Intervention
Chest Pain
Other: Echocardiography with strain analysis

Study Type: Observational
Study Design: Observational Model: Cohort
Time Perspective: Retrospective
Official Title: Use of Echocardiography in the Evaluation of Chest Pain in the Emergency Department

Resource links provided by NLM:

Further study details as provided by New York University School of Medicine:

Enrollment: 118
Study Start Date: June 2005
Primary Completion Date: December 2009 (Final data collection date for primary outcome measure)
Groups/Cohorts Assigned Interventions
entire cohort
patients presenting to the emergency department with chest pain and being admitted to rule out acute coronary syndrome
Other: Echocardiography with strain analysis
Clinical routine echocardiogram with additional off line strain analysis


Ages Eligible for Study:   18 Years and older   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Sampling Method:   Non-Probability Sample
Study Population
All patients presenting to the emergency department with chest pain and are admitted to rule out acute coronary syndrome

Inclusion Criteria:

  1. Age 18 or older
  2. Chief complaint on presentation to ED: chest pain
  3. Differential diagnosis includes acute coronary syndrome as determined by the Emergency physician or admitting attending.
  4. Admission to the hospital required for further cardiac work up.

Exclusion Criteria:

  1. Obvious noncardiac cause of the chest pain
  2. Patient requires urgent intervention before echo can be obtained
  3. Failure to obtain informed consent
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Please refer to this study by its identifier: NCT01125072

United States, New York
NYU School of Medicine, Langone Medical Center
New York, New York, United States, 10016
Sponsors and Collaborators
New York University School of Medicine
  More Information

Responsible Party: New York University School of Medicine Identifier: NCT01125072     History of Changes
Other Study ID Numbers: 05-264
Study First Received: May 14, 2010
Last Updated: November 10, 2016

Keywords provided by New York University School of Medicine:
chest pain
strain imaging

Additional relevant MeSH terms:
Chest Pain
Disease Attributes
Pathologic Processes
Neurologic Manifestations
Nervous System Diseases
Signs and Symptoms processed this record on April 21, 2017