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עמוד בית
Mon, 15.04.24

Original Articles

IMAJ | volume 12

Journal 6, June 2010
pages: 329-333

Fast Track Evaluation of Patients with Acute Chest Pain: Experience in a Large-Scale Chest Pain Unit in Israel

    Summary

    Background:

    Many patients present to the emergency department with chest pain. While in most of them chest pain represents a benign complaint, in some patients it underlies a life-threatening illness.

    Objectives:

    To assess the routine evaluation of patients presenting to the ED
    [1] with acute chest pain via the utilization of a cardiologist-based chest pain unit using different non-invasive imaging modalities.

    Methods:

    We evaluated the records of 1055 consecutive patients who presented to the ED with complaints of chest pain and were admitted to the CPU
    [2]. After an observation period and according to the decision of the attending cardiologist, patients underwent myocardial perfusion scintigraphy, multidetector computed tomography, or stress echocardiography.

    Results:

    The CPU attending cardiologist did not prescribe non-invasive evaluation for 108 of the 1055 patients, who were either admitted (58 patients) or discharged (50 patients) after an observation period. Of those remaining, 445 patients underwent MDCT
    [3], 444 MPS[4], and 58 stress echocardiography. Altogether, 907 patients (86%) were discharged from the CPU. During an average period of 236 ± 223 days, 25 patients (3.1%) were readmitted due to chest pain of suspected cardiac origin, and only 8 patients (0.9%) suffered a major adverse cardiovascular event.

    Conclusions:

    Utilization of the CPU enabled a rapid and thorough evaluation of the patients’ primary complaint, thereby reducing hospitalization costs and occupancy on the one hand and avoiding misdiagnosis in discharged patients on the other.

     

    [1] ED = emergency department
    [2] CPU = chest pain unit
    [3] MDCT = multidetector computed tomography
    [4] MPS = myocardial perfusion scintigraphy

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