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January 31, 1977

Hospitalization for Possible Myocardial Infarction

Author Affiliations

Culver City, Calif

JAMA. 1977;237(5):449. doi:10.1001/jama.1977.03270320027011

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To the Editor.—  The article by Schor et al (236:941,1976) ended with some unusual comments. Agreed that it is extremely "disturbing" to find an error rate of 10% of acute myocardial infarctions undiagnosed, remedial actions should include consideration of hospitalization of more suspected cases, even if this "transfers the increased false-positive rate to the holding ward." Certainly that is the purpose of a holding ward, and statistics notwithstanding, the primary reason for observation is to prevent harm to a patient. Even "if a procedure of delay is instituted" and more patients go to the ward rather than the coronary care unit, they are at least in the hospital (where acute management can be readily instituted if needed) rather than at home. The suggestion that patients denied admission should "return within a month for a checkup" seems to be an inappropriate suggestion; follow-up at two or three days to identify any