AI Article Synopsis
- Acute chest pain, often non-traumatic, frequently leads patients to seek medical attention, with coronary heart disease accounting for about 25% of cases, requiring urgent and focused treatment due to associated mortality risks.
- The diagnostic process begins with patient history, physical exams, and a 12-lead ECG, which can reveal serious conditions like ST-segment elevation that necessitate cardiac catheterization; reliable troponin tests help in diagnosing or ruling out heart attacks.
- Acknowledging diverse causes like vascular, musculoskeletal, or psychosomatic issues is crucial, especially in elderly patients, as misdiagnoses often stem from missed important conditions and insufficient diagnostic efforts, highlighting the need for improved interdisciplinary approaches in managing chest pain.
Article Abstract
Background: Acute chest pain of non-traumatic origin is a common reason for presentation to physician's offices and emergency rooms. Coronary heart disease is the cause in up to 25% of cases. Because acute chest pain, depending on its etiology, may be associated with a high risk of death, rapid, goal-oriented management is mandatory.
Methods: This review is based on pertinent articles and guidelines retrieved by a selective search in PubMed.
Results: History-taking, physical examination, and a 12-lead electrocardiogram (ECG) are the first steps in the differential diagnostic process and generally allow the identification of features signifying a high risk of lifethreatening illness. If the ECG reveals ST-segment elevation, cardiac catheterization is indicated. The timedependent measurement of highly sensitive troponin values is a reliable test for the diagnosis or exclusion of acute myocardial infarction. A wide variety of other potential causes (e.g., vascular, musculoskeletal, gastroenterologic, or psychosomatic) must be identified from the history if they are to be treated appropriately. Elderly patients need special attention.
Conclusion: Acute chest pain is a major diagnostic challenge for the physician. Common errors are traceable to non-recognition of important causes and to an inadequate diagnostic work-up. Future studies should be designed to help optimize the interdisciplinary management of patients with chest pain.
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|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4660855 | PMC |
| http://dx.doi.org/10.3238/arztebl.2015.0768 | DOI Listing |
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