ED Acute Chest Pain Imaging Protocol


This protocol is for patients presenting to the ED with suspected low risk ACS


Inclusion criteria to be followed by ED for entry into protocol

Patient arrives to ED with ONGOING CP and fits criteria to perform nuclear chest pain imaging

Nuclear medicine tech will come to the ED and inject the patient with sestamibi within 60 minutes and EMS will transport patient to radiology department for chest images.  The patient can be scanned within 3 hours of injection.  The appropriate computer order is:

Myocardial Imaging Tomography Spectroscopy Single

which may be found under the Radiology/Nuclear Medicine order screen.


If images are positive (indicating presence of CAD or ACS) admit pt. to CACU from ED

If the images are Probably normal or show attenuation artifact, the recommendation is to admit the patient for complete test. If images are negative, and 3 neg. troponins, the patient can be discharged to home if clinically stable with a prescription to return for complete a stress test 48 hours later.

Patient returns to non-invasive cardiology as outpatient in 48 hours for complete stress test.


Hours of operation:
    Although it may be available at other hours, the usual hours of operation are:
    Monday - Friday 8A-4P
    Saturday 8A-1P

Phone numbers:  4-5211 to arrange for first ED sestamibi study
Phone numbers:  4-1770 to schedule 48 hour stress