Literature Review: the value of a recent negative stress test in the evaluation of acute coronary syndromes (ACS)

Emergency Cardiology Literature Review & Updates with Dr. Amal Mattu


A 55-year-old woman presents to the emergency department with severe recurrent chest pain and shortness of breath associated with sweating. She reports being at a different hospital 3 days ago where she was hospitalized and had a negative exercise stress test. The following ECG is obtained with no prior ECGs available for comparison:

Before watching the video, look closely at this ECG and ask yourself:

  1. What ECG abnormalities do you notice?
  2. Are there any signs of ischemia or infarction?
  3. Does a recent negative stress test rule out the possibility of CAD or ACS?