Study objective: The purpose of this study was to determine if thallium-201 myocardial planar imaging and technetium-99m first-pass radionuclide angiography, performed in the emergency department, could predict which patients with acute chest pain and nondiagnostic ECGs were more likely to have an acute myocardial infarction (AMI).
Design: Retrospective analysis.
Setting: Urban, county ED.
Type of participants: Convenience sample of 47 patients with acute chest pain suggestive of myocardial ischemia and nondiagnostic ECG.
Interventions: Thallium-201 myocardial imaging and technetium-99m first-pass radionuclide angiography in the ED.
Measurements and main results: Four patients had an AMI (ie, CK-MB greater than or equal to 6% total CK). The combined scans had a sensitivity of 75%, (95% confidence interval [Cl], 19-99%), a specificity of 42% (95% CI, 27-58%), an accuracy of 45% (95% CI, 19-99%), a positive predictive value of 11% (95% CI, 2-29%), and a negative predictive value of 95% (95% CI, 75-100%) in predicting AMI.
Conclusion: Thallium-201 myocardial planar imaging and technetium-99m first-pass radionuclide angiography performed in the ED do not appear to be useful in determining which patients with acute chest pain and nondiagnostic ECG are likely to have an AMI.