Echocardiography is the first cardiac imaging technique used to evaluate patients presenting with acute coronary syndrome (ACS). However, in the absence of wall motion abnormalities, conventional echocardiography at rest provides little information. Patients presenting with low risk ACS usually have normal wall motion and left ventricle ejection fraction (LVEF) at rest.

Approximately 20% of patients arriving in the crowded emergency departments (ED) present with acute chest pain (ACP) and 60% are admitted in order to rule out an acute coronary syndrome (ACS). In the latter category, the ACS is confirmed only in 15% of patients thus resulting in a huge number of unnecessary admissions and wasted resources. (1) Stratifying ACP as low, moderate or high risk ACS allows physicians to take immediate action, initiate treatment and transfer the patient to the appropriate location.