NEW YORK (Reuters Health) — African American patients who are seen in the ER for chest pain are less likely than patients from other racial groups to receive standard tests, such as a chest x-ray or an electrocardiogram (ECG), which provides an electrical recording of the heart, new research shows. The findings also suggest differences in chest pain evaluation based on gender and insurance status. “A number of studies have looked at racial and gender differences” in the provision of cardiovascular treatments, lead author Dr. Liliana E. Pezzin, from the Medical College of Wisconsin in Milwaukee, told Reuters Health. However, “few studies have examined how race, gender, and insurance status may affect the evaluation of chest pain in the ER setting.”To investigate, Pezzin and colleagues took a look back at 7,068 patients seen in a hospital ER for a primary complaint of chest pain between 1995 and 2000.

As mentioned, African American patients were less likely than non-African Americans to be evaluated with ECG, chest x-ray, cardiac monitoring, and pulse oximetry, which measures blood oxygen levels.

African American men had the lowest rates of EXF and chest x-ray usage, 74.3 percent and 62.0 percent, respectively. The corresponding rates in non-African American men were 81.1 percent and 70.3 percent.

African American women had the lowest rates of cardiac monitoring and pulse oximetry, 37.5 percent and 41.8 percent, respectively. The corresponding rates in non-African American men were 54.5 percent and 55.8 percent. Insurance status also seemed to influence the chest pain work-up. Uninsured, self-pay, or patients with “other” insurance were less likely to receive the tests studied than were insured patients.