Here are a few pearls about how to choose stress tests for patients presenting with CP that you’re admitting to the observation unit.
Caveat #1: Much of this is specific to our observation at the Mayo Clinic. We have access to a multiude of provocative tests including EKG treadmills, Adenosine, Dobutamine, and exercise sestamibis, exercise and Dobutamine stress echocardiograms, cardiology consultations, and next day cardiology follow-up appoints.
Caveat #2: This is not a discussion of the utility and evidence or lack-there-of for stress tests in low risk chest pain patients. Rather, during an emergency medicine residency and working in an emergency department with an observation unit, a resident will order a lot of stress tests as it is part of the practice of many Emergency Medicine Attending physicians. Given this, it is important to know some tips / tricks on how to select the most appropriate test.