Effects of cardiology review of the electrocardiogram in patients with suspected acute coronary syndromes

One hundred forty-nine ECGs were faxed to a cardiology fellow. One hundred twenty cases were analyzed. Excluded were AMA/eloped/ineligible (n = 11) and those whose cardiology forms were unavailable (n = 18). Subjects were aged (median) 50.5 years (range, 24-93 years), 50% (n = 60) were female, and 87.5% (n = 105) had cardiac markers in ED. Cardiology ECG review triggered callback in 6 cases (5.0%; 95% confidence interval, 1.5%-10.9%) with documented discussion with a cardiology fellow about treatment. In 3 cases (2.5%; 95% confidence interval, 0.5%-7.1%), disposition was changed to coronary care unit and cardiac catheterization consulted, although none were emergently treated.