Bedside diagnosis of coronary artery disease: A systematic review

摘要: Purpose To assess the accuracy of bedside findings for diagnosing coronary artery disease and acute myocardial infarction. Methods A MEDLINE search was performed to retrieve articles published from January 1966 2003 that were relevant diagnosis in adults. Results In patients with stable, intermittent chest pain, most useful predictors a found be presence typical angina (likelihood ratio [LR] = 5.8; 95% confidence interval [CI]: 4.2 7.8), serum cholesterol level >300 mg/dL (LR 4.0; CI: 2.5 6.3), history prior infarction 3.8; 2.1 6.8), age >70 years 2.6; 1.8 4.0). Nonanginal pain 0.1; 0.1 0.2), duration >30 minutes 0.0 0.9), dysphagia 0.2; 0.8) argued against disease. important new ST elevation 22; 16 30), Q waves 7.6 62), depression 4.5; 3.6 5.6). normal electrocardiogram 0.3), wall tenderness 0.3; 0.2 0.4), pleuritic sharp 0.5), or positional 0.5) Conclusion The depends on clinical setting. evaluation patient's description predictor underlying Aside extremes values, analysis traditional risk factors changed probability very little not at all.