Assessment of Acute Disease to Reduce Imaging Costs

Inclusion Criteria

• •Adult (\>17 years) ED patient reports a history of chest discomfort and new or worsened shortness of breath or breathing difficulty, documented in the written history of present illness or review of systems.
• •Patient must understand English or have a certified translator present.
• •Physician has ordered or plans to order a 12-lead electrocardiogram.
• •Patient indicates the site hospital was his or her "hospital of choice" in the event of return visit within 14 days.
• •Randomization Exclusions
• •Positive urine cocaine test.
• •Incarceration within 14 days of enrollment.
• •Patient elopement from medical care (i.e., patients who leave against medical advice).