Comparison of digital with videotape echocardiography in patients with chest pain in the emergency department.

We prospectively compared digital echocardiographic images, by a minimal digital-acquisition strategy, with videotape images to determine the diagnostic utility of digital imaging in patients admitted to the emergency department with chest pain. Digital acquisition has many potential advantages for evaluating echocardiographic images, especially in the acute-care setting. It is not yet known how much the imaging study can be condensed with digital technology and still provide the necessary information needed for clinical echocardiographic diagnosis. One hundred seventeen patients with diagnoses consisting of coronary artery disease, pericardial disease, and valvular disease were studied. Overall agreement between videotape and digital recordings with regard to normal versus abnormal wall motion was 94% (p < 0.001). The wall motion score index, a semiquantitative measure of global function, also correlated well (r = 0.94). Complete concordance was noted in all patients with aortic stenosis and pericardial effusion. Digital echocardiographic imaging, by a minimal-acquisition strategy, is an accurate summary of the complete echocardiographic examination and provides the relevant diagnostic data needed for the assessment of patients with chest pain in the emergency department.