In patients with suspected coronary artery disease, which test would be least helpful for confirming acute coronary syndrome?

In the evaluation of patients with suspected coronary artery disease, the least helpful test for confirming acute coronary syndrome is a chest X-ray. While this imaging technique can provide valuable information regarding the heart's size, shape, and surrounding structures, it does not specifically assess the coronary arteries or indicate ischemia, which are central to diagnosing acute coronary syndrome.

On the other hand, an electrocardiogram (ECG) is critical for detecting electrical changes in the heart that may indicate an ongoing heart attack. Cardiac enzyme tests measure biomarkers released into the bloodstream during myocardial injury, providing clear indications of heart damage. Coronary angiography directly visualizes the coronary arteries, allowing for precise determination of blockages and assessing the severity of coronary artery disease.

Therefore, while a chest X-ray can be part of a comprehensive assessment, it does not provide the specific information needed to confirm or rule out acute coronary syndrome.