The use of these classifications and definitions in the ED is problematic. When patients present with acute chest pain syndromes, it is often not clear whether the chest pain is cardiac or noncardiac in origin. The proper application of both the Canadian Cardiovascular Society Classification and the AHCPR guidelines assumes a diagnosis of ischemic chest pain. These guidelines can be difficult to incorporate into emergency practice, where the diagnosis is often uncertain. They are not as useful as other methods to assess risk of an acute cardiac event or adverse events (T§b.!®...4Z:3).
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