American society of nuclear cardiology position statement on radionuclide imaging in patients with suspected acute ischemic syndromes in the emergency department or chest pain center

The initial evaluation of patients presenting to emergency departments with chest pain of suspected cardiac origin is critical in determining hospital admission or discharge. Clinical evaluation alone has been unsatisfactory as a complete triage tool in this setting. This has resulted in numerous unnecessary hospital admissions, as well as unfortunate hospital discharge of patients with coronary artery disease. The situation has become more critical as hospitals, particularly in large metropolitan centers, are above capacity, resulting in closing of hospital admitting and emergency departments to critically ill patients. Acute rest myocardial perfusion imaging has been clearly documented as an extremely useful tool in the evaluation of such patients. However, uniform standards have been lacking. This position statement by an American Society of Nuclear Cardiology task force on chest pain centers clearly demonstrates the value of acute rest myocardial perfusion imaging in the triage of patients with suspected acute coronary syndromes. The document further elucidates steps necessary for such evaluation and the type of patients for whom this evaluation is best suited. As such, the document furthers our appreciation of acute rest myocardial perfusion imaging in the emergency setting.