CHEST PAIN IN THE EMERGENCY DEPARTMENT: DIAGNOSIS AND MANAGEMENT
Main Article Content
Keywords
Chest Pain, Diagnosis, Management.
Abstract
Chest pain presents as a prevalent symptom, covering a wide range of potential diagnoses, some of which pose serious threats to life. This symptom ranks as the second most frequent complaint encountered in emergency care settings, accounting for around 5% of all visits to the emergency department. This review is a comprehensive research of PUBMED from 1996 to 2019, designed to discuss the diagnosis and management of chest pain in the emergency room.
References
1. Jänig W: Neurobiology of visceral pain. Der Schmerz. 2014, 28:233-251.
2. Eslick GD, Fass R: Noncardiac chest pain: evaluation and treatment. Gastroenterology Clinics. 2003, 32:531-552.
3. Members WG, Lloyd-Jones D, Adams RJ, et al.: Heart disease and stroke statistics—2010 update: a report from the American Heart Association. Circulation. 2010, 121:e46-e215.
4. Opolot J: Chest pain: An approach for family practice. South African Family Practice. 2006, 48:30-33.
5. Fitzpatrick R: Surveys of patients satisfaction: I--Important general considerations. BMJ: British Medical Journal. 1991, 302:887.
6. Stochkendahl MJ, Christensen HW: Chest pain in focal musculoskeletal disorders. Medical Clinics. 2010, 94:259-273.
7. Sabatine MS, Cannon CP: Approach to the patient with chest pain. In: Braunwald’s Heart Disease: A Textbook of Cardiovascular Medicine 9th ed Philadelphia, PA: Elsevier/Saunders. 2012:1076-1086.
8. Cayley Jr WE: Diagnosing the cause of chest pain. American family physician. 2005, 72:2012-2021.
9. Oranu AC, Vaezi MF: Noncardiac chest pain: gastroesophageal reflux disease. Medical Clinics. 2010, 94:233-242.
10. Brims FJ, Davies HE, Lee YG: Respiratory chest pain: diagnosis and treatment. Medical Clinics. 2010, 94:217-232.
11. Ruigómez A, Massó-González EL, Johansson S, Wallander M-A, García-Rodríguez LA: Chest pain without established ischaemic heart disease in primary care patients: associated comorbidities and mortality. British Journal of General Practice. 2009, 59:e78-e86.
12. Yelland M, Cayley WE, Vach W: An algorithm for the diagnosis and management of chest pain in primary care. Medical Clinics. 2010, 94:349-374.
13. Mason RJ, Broaddus VC, Martin TR, et al.: Murray and Nadel's textbook of respiratory medicine E-book: 2-volume set. Elsevier Health Sciences, 2010.
14. Jones ID, Slovis CM: Pitfalls in evaluating the low-risk chest pain patient. Emergency Medicine Clinics. 2010, 28:183-201.
15. Haro LH, Decker WW, Boie ET, Wright RS: Initial approach to the patient who has chest pain. Cardiology clinics. 2006, 24:1-17.
16. Karnath B, Holden MD, Hussain N: Chest pain: differentiating cardiac from noncardiac causes. Hospital Physician. 2004, 38:24-27.
17. Patel JH, Gupta R, Roe MT, Peng SA, Wiviott SD, Saucedo JF: Influence of presenting electrocardiographic findings on the treatment and outcomes of patients with non–ST-segment elevation myocardial infarction. The American Journal of Cardiology. 2014, 113:256-261.
18. Bruno RR, Donner-Banzhoff N, Söllner W, Frieling T, Müller C, Christ M: The interdisciplinary management of acute chest pain. Deutsches Ärzteblatt International. 2015, 112:768.
19. Fruergaard P, Launbjerg J, Hesse B: Frequency of pulmonary embolism in patients admitted with chest pain and suspicion of acute myocardial infarction but in whom this diagnosis is ruled out. Cardiology. 1996, 87:331-334.
20. Fruergaard P, Launbjerg J, Hesse B, et al.: The diagnoses of patients admitted with acute chest pain but without myocardial infarction. European heart journal. 1996, 17:1028-1034.
21. Amsterdam EA, Kirk JD: Chest pain units. Cardiology Clinics. 2005, 23:xiii-xiv.
22. Thygesen K, Alpert JS, Jaffe AS, Simoons ML, Chaitman BR, White HD: Third universal definition of myocardial infarction. circulation. 2012, 126:2020-2035.
23. Members ATF, Hamm CW, Bassand J-P, et al.: ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: The Task Force for the management of acute coronary syndromes (ACS) in patients presenting without persistent ST-segment elevation of the European Society of Cardiology (ESC). European heart journal. 2011, 32:2999-3054.
24. King SB, Lembo NJ, Weintraub WS, et al.: A randomized trial comparing coronary angioplasty with coronary bypass surgery. New England Journal of Medicine. 1994, 331:1044-1050.
25. Brush Jr JE, Brand DA, Acampora D, Chalmer B, Wackers FJ: Use of the initial electrocardiogram to predict in-hospital complications of acute myocardial infarction. New England Journal of Medicine. 1985, 312:1137-1141.
26. Mair J, Apple F: Progress in myocardial damage detection: new biochemical markers for clinicians. Critical Reviews in Clinical Laboratory Sciences. 1997, 34:1-66.
27. Graff LG, Dallara J, Ross MA, et al.: Impact on the care of the emergency department chest pain patient from the chest pain evaluation registry (CHEPER) study. The American journal of cardiology. 1997, 80:563-568.
28. Shokoohi H, Boniface KS, Zaragoza M, Pourmand A, Earls JP: Point-of-care ultrasound leads to diagnostic shifts in patients with undifferentiated hypotension. The American Journal of Emergency Medicine. 2017, 35:1984. e1983-1984. e1987.
29. Solhpour A, Chang KW, Arain SA, et al.: Comparison of 30‐day mortality and myocardial scar indices for patients treated with prehospital reduced dose fibrinolytic followed by percutaneous coronary intervention versus percutaneous coronary intervention alone for treatment of ST‐elevation myocardial infarction. Catheterization and Cardiovascular Interventions. 2016, 88:709-715.
30. Khoynezhad A, Plestis KA: Managing emergency hypertension in aortic dissection and aortic aneurysm surgery. Journal of Cardiac Surgery. 2006, 21:S3-S7.
31. Shiber JR, Fontane E, Ra JH, Kerwin AJ: Hydropneumothorax due to esophageal rupture. Journal of Emergency Medicine. 2017, 52:856-858.
32. Zhao DL, Liu XD, Zhao CL, et al.: Multislice spiral CT angiography for evaluation of acute aortic syndrome. Echocardiography. 2017, 34:1495-1499.
33. Jindal A, Singhi S: Acute chest pain. The Indian Journal of Pediatrics. 2011, 78:1262-1267.
2. Eslick GD, Fass R: Noncardiac chest pain: evaluation and treatment. Gastroenterology Clinics. 2003, 32:531-552.
3. Members WG, Lloyd-Jones D, Adams RJ, et al.: Heart disease and stroke statistics—2010 update: a report from the American Heart Association. Circulation. 2010, 121:e46-e215.
4. Opolot J: Chest pain: An approach for family practice. South African Family Practice. 2006, 48:30-33.
5. Fitzpatrick R: Surveys of patients satisfaction: I--Important general considerations. BMJ: British Medical Journal. 1991, 302:887.
6. Stochkendahl MJ, Christensen HW: Chest pain in focal musculoskeletal disorders. Medical Clinics. 2010, 94:259-273.
7. Sabatine MS, Cannon CP: Approach to the patient with chest pain. In: Braunwald’s Heart Disease: A Textbook of Cardiovascular Medicine 9th ed Philadelphia, PA: Elsevier/Saunders. 2012:1076-1086.
8. Cayley Jr WE: Diagnosing the cause of chest pain. American family physician. 2005, 72:2012-2021.
9. Oranu AC, Vaezi MF: Noncardiac chest pain: gastroesophageal reflux disease. Medical Clinics. 2010, 94:233-242.
10. Brims FJ, Davies HE, Lee YG: Respiratory chest pain: diagnosis and treatment. Medical Clinics. 2010, 94:217-232.
11. Ruigómez A, Massó-González EL, Johansson S, Wallander M-A, García-Rodríguez LA: Chest pain without established ischaemic heart disease in primary care patients: associated comorbidities and mortality. British Journal of General Practice. 2009, 59:e78-e86.
12. Yelland M, Cayley WE, Vach W: An algorithm for the diagnosis and management of chest pain in primary care. Medical Clinics. 2010, 94:349-374.
13. Mason RJ, Broaddus VC, Martin TR, et al.: Murray and Nadel's textbook of respiratory medicine E-book: 2-volume set. Elsevier Health Sciences, 2010.
14. Jones ID, Slovis CM: Pitfalls in evaluating the low-risk chest pain patient. Emergency Medicine Clinics. 2010, 28:183-201.
15. Haro LH, Decker WW, Boie ET, Wright RS: Initial approach to the patient who has chest pain. Cardiology clinics. 2006, 24:1-17.
16. Karnath B, Holden MD, Hussain N: Chest pain: differentiating cardiac from noncardiac causes. Hospital Physician. 2004, 38:24-27.
17. Patel JH, Gupta R, Roe MT, Peng SA, Wiviott SD, Saucedo JF: Influence of presenting electrocardiographic findings on the treatment and outcomes of patients with non–ST-segment elevation myocardial infarction. The American Journal of Cardiology. 2014, 113:256-261.
18. Bruno RR, Donner-Banzhoff N, Söllner W, Frieling T, Müller C, Christ M: The interdisciplinary management of acute chest pain. Deutsches Ärzteblatt International. 2015, 112:768.
19. Fruergaard P, Launbjerg J, Hesse B: Frequency of pulmonary embolism in patients admitted with chest pain and suspicion of acute myocardial infarction but in whom this diagnosis is ruled out. Cardiology. 1996, 87:331-334.
20. Fruergaard P, Launbjerg J, Hesse B, et al.: The diagnoses of patients admitted with acute chest pain but without myocardial infarction. European heart journal. 1996, 17:1028-1034.
21. Amsterdam EA, Kirk JD: Chest pain units. Cardiology Clinics. 2005, 23:xiii-xiv.
22. Thygesen K, Alpert JS, Jaffe AS, Simoons ML, Chaitman BR, White HD: Third universal definition of myocardial infarction. circulation. 2012, 126:2020-2035.
23. Members ATF, Hamm CW, Bassand J-P, et al.: ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: The Task Force for the management of acute coronary syndromes (ACS) in patients presenting without persistent ST-segment elevation of the European Society of Cardiology (ESC). European heart journal. 2011, 32:2999-3054.
24. King SB, Lembo NJ, Weintraub WS, et al.: A randomized trial comparing coronary angioplasty with coronary bypass surgery. New England Journal of Medicine. 1994, 331:1044-1050.
25. Brush Jr JE, Brand DA, Acampora D, Chalmer B, Wackers FJ: Use of the initial electrocardiogram to predict in-hospital complications of acute myocardial infarction. New England Journal of Medicine. 1985, 312:1137-1141.
26. Mair J, Apple F: Progress in myocardial damage detection: new biochemical markers for clinicians. Critical Reviews in Clinical Laboratory Sciences. 1997, 34:1-66.
27. Graff LG, Dallara J, Ross MA, et al.: Impact on the care of the emergency department chest pain patient from the chest pain evaluation registry (CHEPER) study. The American journal of cardiology. 1997, 80:563-568.
28. Shokoohi H, Boniface KS, Zaragoza M, Pourmand A, Earls JP: Point-of-care ultrasound leads to diagnostic shifts in patients with undifferentiated hypotension. The American Journal of Emergency Medicine. 2017, 35:1984. e1983-1984. e1987.
29. Solhpour A, Chang KW, Arain SA, et al.: Comparison of 30‐day mortality and myocardial scar indices for patients treated with prehospital reduced dose fibrinolytic followed by percutaneous coronary intervention versus percutaneous coronary intervention alone for treatment of ST‐elevation myocardial infarction. Catheterization and Cardiovascular Interventions. 2016, 88:709-715.
30. Khoynezhad A, Plestis KA: Managing emergency hypertension in aortic dissection and aortic aneurysm surgery. Journal of Cardiac Surgery. 2006, 21:S3-S7.
31. Shiber JR, Fontane E, Ra JH, Kerwin AJ: Hydropneumothorax due to esophageal rupture. Journal of Emergency Medicine. 2017, 52:856-858.
32. Zhao DL, Liu XD, Zhao CL, et al.: Multislice spiral CT angiography for evaluation of acute aortic syndrome. Echocardiography. 2017, 34:1495-1499.
33. Jindal A, Singhi S: Acute chest pain. The Indian Journal of Pediatrics. 2011, 78:1262-1267.
Article Sidebar
Published
May 10, 2020
Article Details
How to Cite
Mansour Ibrahim Mohammed Kaabi, Hussain Mansour Mobark Abu Alsaud, Talal Mohammed Alshammari, Alaa Essa AlMulla, Manal Ahmed Alsuwailim, Nadia Abdullatif Aldossary, Ali Ghanem Ali Haqawi, Moteea Abduladhim Alhaddad, Salma Ebrahim Alquhaidan, Wadha Hamad Manee Alanazi, Fatimah Ali Ebrahim Alzaher, Dalal Ahmed Ali Albandri, Ahmed Salah Alnujaim, Abdullah Saeed Alshehri, & Fahad Ibrahim Alotaibi. (2020). CHEST PAIN IN THE EMERGENCY DEPARTMENT: DIAGNOSIS AND MANAGEMENT. Journal of Population Therapeutics and Clinical Pharmacology, 27(2), 124-131. https://doi.org/10.53555/jptcp.v27i2.6341
Section
Articles
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Author Biographies
Mansour Ibrahim Mohammed Kaabi
Primary healthcare - National Guard – Dammam
Hussain Mansour Mobark Abu Alsaud
Primary healthcare - National Guard – Dammam
Talal Mohammed Alshammari
Primary healthcare - National Guard – Dammam
Alaa Essa AlMulla
Primary healthcare - National Guard – Dammam
Manal Ahmed Alsuwailim
Primary healthcare - National Guard – Dammam
Nadia Abdullatif Aldossary
Primary healthcare - National Guard – Dammam
Ali Ghanem Ali Haqawi
Primary healthcare - National Guard – Dammam
Moteea Abduladhim Alhaddad
Primary healthcare - National Guard – Dammam
Salma Ebrahim Alquhaidan
Primary healthcare - National Guard – Dammam
Wadha Hamad Manee Alanazi
Primary healthcare - National Guard – Dammam
Fatimah Ali Ebrahim Alzaher
Primary healthcare - National Guard – Dammam
Dalal Ahmed Ali Albandri
Primary healthcare - National Guard – Dammam
Ahmed Salah Alnujaim
Primary healthcare - National Guard – Dammam
Abdullah Saeed Alshehri
Primary healthcare - National Guard – Dammam
Fahad Ibrahim Alotaibi
Primary healthcare - National Guard – Dammam
How to Cite
Mansour Ibrahim Mohammed Kaabi, Hussain Mansour Mobark Abu Alsaud, Talal Mohammed Alshammari, Alaa Essa AlMulla, Manal Ahmed Alsuwailim, Nadia Abdullatif Aldossary, Ali Ghanem Ali Haqawi, Moteea Abduladhim Alhaddad, Salma Ebrahim Alquhaidan, Wadha Hamad Manee Alanazi, Fatimah Ali Ebrahim Alzaher, Dalal Ahmed Ali Albandri, Ahmed Salah Alnujaim, Abdullah Saeed Alshehri, & Fahad Ibrahim Alotaibi. (2020). CHEST PAIN IN THE EMERGENCY DEPARTMENT: DIAGNOSIS AND MANAGEMENT. Journal of Population Therapeutics and Clinical Pharmacology, 27(2), 124-131. https://doi.org/10.53555/jptcp.v27i2.6341