Assessment of chest pain in the emergency room. The role of nuclear cardiology

patient admitted to the Emergency Room with chest pain syndrome has always been a challenge for the cardiologist. About one third of the patients sent home come back with an acute myocardial infarction (AMI) 1,2 and in about one third of those admitted to the Coronary Unit the AMI diagnosis cannot be confirmed. 3,4 Frequently, the conservative behavior of observation and/ or diagnostic wait is opted for, which increases the number of patients being admitted at the Intensive Care Coronary Unit (ICCU) and overpopulates this critical, costly and fast mobility area. This scenery also serves the risk of iprofessional liabilityi lawsuits. 5 In the 1985-90 period, a 25% reduction of AMI morbidity and mortality was achieved, 6 thanks to a better knowledge of the etiopathogenesis, the continuous development of new technologies that provide a fast and reliable diagnosis, and very specially to the immediate use of new revascularization techniques. Finally, education of the medical staff and the public in general, with respect to primary and secondary means of ischemic coronary heart disease (CHD) prevention, have also