Acute rest myocardial perfusion imaging for chest pain

Conclusions  Rest radionuclide MPI has made a substantial impact on how patients presenting with acute chest pain are triaged in EDs. Because of the high negative predictive value and favorable prognosis of patients with acute chest pain and normal rest MPI, emergency medicine physicians feel more confident that these patients can be safely discharged. The practice of performing subsequent stress testing in patients with normal rest MPI or normal serial biomarkers has substantially improved the quality of care of patients presenting to the ED with acute chest discomfort. Patients with acute chest pain who undergo a full diagnostic workup as outlined above, including acute rest MPI, benefit from a quick and complete cardiologic evaluation. This is in contrast to the old practice of unnecessary hospitalization for several days or unfortunate discharge from the ED with an evolving acute coronary syndrome. When incorporated into clinical pathways, rest MPI has contributed to improved clinical outcomes by decreasing the number of missed myocardial infarcts, reducing unnecessary admissions, and lowering overall costs when compared with standard patient management.