A multidisciplinary approach to chest pain evaluation and management.

Chest pain evaluation centers in emergency departments efficiently exclude acute myocardial infarctions but are limited in identifying patients with acute cardiac ischemia (ACI) without infarction. Short-term prognosis is similar for patients discharged with ACI and for those who had an infarction. Subsequently, for suspected ACI, cardiology or primary care is consulted, providing follow-up coronary angiography or stress testing, but often requiring repeat labwork and resulting in significant time delays. A coordinated approach to chest pain management--an early multidisciplinary effort--provides an efficient and cost-effective approach to chest pain evaluation and management, while reducing potentially dangerous delays in identifying ACI.