Researchers studied patients aged 18 to 40 who were evaluated for acute coronary syndrome in an ED-based observation unit. Two hundred thirty-nine patients received stress testing, resulting in five positive and nine indeterminate results. The positive stress test patients and a patient under observation who had acute troponin elevation underwent cardiac angiography. Only one patient showed significant coronary stenosis and received coronary interventions.
One year after the ED visit, only one patient had had an adverse cardiac outcome, and the patient did not have a coronary intervention.
The authors concluded that observation and stress testing should not be performed routinely in young adults who do not have other high-risk features.
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