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The Role of Emergency Physicians on the Management of Chest Pain

Year 2016, Volume: 6 Issue: 1, 30 - 34, 26.02.2016
https://doi.org/10.16899/ctd.34656

Abstract

Background and Objective: Chest pain is a common and important admission complaint of patients in the emergency department (ED).  The differential diagnosis especially in terms of acute coronary syndrome (ACS) should be done carefully by emergency physicians. The present study aims to identify patients with chest pain according to presence of ACS in the ED.

Material and Methods: The patients who admitted to the ED of a university hospital in a year period with chest pain complaint were enrolled into the study prospectively. The information that include  age, gender, type of chest pain, duration of pain, medical history, transporting way to the ED, duration time of electrocardiography (ECG) recording, main diagnosis, consultation status, last condition of patients and length of stay of patients were recorded. The data were analyzed by SPSS 17.0 program.

Results: Totally 325 patients with chest pain complaint were enrolled into the study. 24.3% of patients with chest pain were diagnosed as ACS.It was found that most of the patients (42.5%) came to ED by the ambulance.110 (33.8%) of 325 patients with chest pain were consulted with cardiologists.  The older age was found to be related with ACS significantly (p<0.001). Additionally; compressive, burning and squeezing types of chest pain were associated with ACS (p<0.040). The length of stay in the ED was found shorter in ACS+ group than ACS- group (p<0.001).

Conclusion: The presented study indicates the role of emergency physicians on the management of patients with chest pain. The early and true diagnosis of patients is very important and essential particularly for the management of ACS in the ED.

References

  • REFERENCES
  • Puelacher C, Hillinger P, Wagener M, Muller C. Cardiac biomarkers for infarct diagnosis and early exclusion of acute coronary syndrome. Herz. 2014;39(6):668-71.
  • Mas-Stachurska A, Miro O, Sitges M, de Caralt TM, Perea RJ, Lopez B, et al. Exercise echocardiography and multidetector computed tomography for the evaluation of acute chest pain. Revista espanola de cardiologia. 2015;68(1):17-24.
  • Lipinski MJ, Baker NC, Escarcega RO, Torguson R, Chen F, Aldous SJ, et al. Comparison of conventional and high-sensitivity troponin in patients with chest pain: a collaborative meta-analysis. American heart journal. 2015;169(1):6-16 e6.
  • Smith FG, Brogan RA, Alabas O, Laut KG, Quinn T, Bugiardini R, et al. Comparative care and outcomes for acute coronary syndromes in Central and Eastern European Transitional countries: A review of the literature. European heart journal Acute cardiovascular care. 2014 sep. 11. pii: 2048872614551545.
  • Kılıçaslan İ, Bozan H, Oktay C, Göksu E. Türkiye’de acil servise başvuran hastaların demografik özellikleri. Türkiye Acil Tıp Dergisi. 2005;5(1):5-13.
  • Banu KY, Niyazi OD, Erdem C, Dpekci Afsin DH, Ozlem U, Yasemin C, et al. Value of heart-type fatty acid-binding protein (H-FABP) for emergency department patients with suspected acute coronary syndrome. African health sciences. 2014;14(3):757-62.
  • Bonow RO, Masoudi FA, Rumsfeld JS, DeLong E, Estes NAM, Goff DC, et al. ACC/AHA classification of care metrics: performance measures and quality metrics: a report of the American College of Cardiology/American Heart Association Task Force on Performance Measures. Journal of the American College of Cardiology. 2008;52(24):2113-7.
  • Khursheed M, Fayyaz J, Feroze A, Shakeel N, Bhatti JA. Time to treatment in patients of suspected acute coronary syndrome in Pakistan: A clinical audit. Heart & lung : the journal of critical care. 2015;44(1):63-7.
  • Wu AH, Apple FS, Gibler WB, Jesse RL, Warshaw MM, Valdes R, Jr. National Academy of Clinical Biochemistry Standards of Laboratory Practice: recommendations for the use of cardiac markers in coronary artery diseases. Clinical chemistry. 1999;45(7):1104-21.
  • Kelly AM, Klim S, Soon K. External validation of the GRACE Freedom from Events score in an emergency department 'rule out ACS' chest pain cohort. International journal of cardiology. 2015;179:358-9.
  • Collinson PO, Premachandram S, Hashemi K. Prospective audit of incidence of prognostically important myocardial damage in patients discharged from emergency department. Bmj. 2000;320(7251):1702-5.
  • Tintinalli JE, Stapczynski JS. Tintinalli's emergency medicine: a comprehensive study guide: McGraw-Hill New York; 2011.
  • Schneider SM, Cobaugh DJ, Leahey NF. Gatekeepers: a missed opportunity for safe transport. Academic emergency medicine : official journal of the Society for Academic Emergency Medicine. 1998;5(6):587-92.
  • Noorani MM, Khaliq MF, Shoaib M, Sheikh A, Moughal UE, Moazzum W, et al. Time intervals and associated factors of emergency treatment: first insight into Pakistani system. International archives of medicine. 2014;7(1):41.
  • Özen M, Serinken M, Yilmaz A, Özen Ş. Acil Servise Başvuran Akut Koroner Sendrom Tanılı Hastaların Sosyodemografik ve Klinik Özellikleri. Turkish Journal of Emergency Medicine. 2012;12(3).
  • Karlson BW, Wiklund I, Bengston A, Herlitz J. Prognosis and symptoms one year after discharge from the emergency department in patients with acute chest pain. Chest. 1994;105(5):1442-7.
  • Solinas L, Raucci R, Terrazzino S, Moscariello F, Pertoldi F, Vajto S, et al. Prevalence, clinical characteristics, resource utilization and outcome of patients with acute chest pain in the emergency department. A multicenter, prospective, observational study in north-eastern Italy. Italian heart journal : official journal of the Italian Federation of Cardiology. 2003;4(5):318-24.
  • Hahne K, Lebiedz P, Breuckmann F. Impact of d-Dimers on the Differential Diagnosis of Acute Chest Pain: Current Aspects Besides the Widely Known. Clinical Medicine Insights Cardiology. 2014;8(Suppl 2):1-4.
  • Ceylan Y, Kaya Y, Tuncer M. Akut Koroner Sendrom Kliniği ile Başvuran Hastalarda Koroner Arter Hastalığı Risk Faktörleri. Van Tıp Dergisi. 2011;18(3):147-54.
  • Liu N, Lee MA, Ho AF, Haaland B, Fook-Chong S, Koh ZX, et al. Risk stratification for prediction of adverse coronary events in emergency department chest pain patients with a machine learning score compared with the TIMI score. International journal of cardiology. 2014;177(3):1095-7.
  • Dedeoğlu E, Topaçoğlu H. The Relation Between The Intensity Of Chest Pain Of The People Who Applied To Emergency Room With Their Chest Pain Complaints With St Segment Changes And Acute Coronary Syndrome. Tr J Emerg Med}.11:99-103.
  • Koukkunen H, Pyörälä K, Halinen MO. Low-risk patients with chest pain and without evidence of myocardial infarction may be safely discharged from emergency department. European heart journal. 2004;25(4):329-34.

The Role of Emergency Physicians on the Management of Chest Pain

Year 2016, Volume: 6 Issue: 1, 30 - 34, 26.02.2016
https://doi.org/10.16899/ctd.34656

Abstract

Giriş ve Amaç: Göğüs ağrısı, acil serviste yaygın ve önemli bir başvuru şikayetidir. Özellikle akut koroner sendromu (AKS) içeren ayırıcı tanı acil servis hekimleri tarafından dikkatlice yapılmalıdır. Sunulan bu calışma acil servise göğüs ağrısı şikayeti ile gelen hastaların AKS olup olmamalarına göre incelenmesini amaçlamaktadır

References

  • REFERENCES
  • Puelacher C, Hillinger P, Wagener M, Muller C. Cardiac biomarkers for infarct diagnosis and early exclusion of acute coronary syndrome. Herz. 2014;39(6):668-71.
  • Mas-Stachurska A, Miro O, Sitges M, de Caralt TM, Perea RJ, Lopez B, et al. Exercise echocardiography and multidetector computed tomography for the evaluation of acute chest pain. Revista espanola de cardiologia. 2015;68(1):17-24.
  • Lipinski MJ, Baker NC, Escarcega RO, Torguson R, Chen F, Aldous SJ, et al. Comparison of conventional and high-sensitivity troponin in patients with chest pain: a collaborative meta-analysis. American heart journal. 2015;169(1):6-16 e6.
  • Smith FG, Brogan RA, Alabas O, Laut KG, Quinn T, Bugiardini R, et al. Comparative care and outcomes for acute coronary syndromes in Central and Eastern European Transitional countries: A review of the literature. European heart journal Acute cardiovascular care. 2014 sep. 11. pii: 2048872614551545.
  • Kılıçaslan İ, Bozan H, Oktay C, Göksu E. Türkiye’de acil servise başvuran hastaların demografik özellikleri. Türkiye Acil Tıp Dergisi. 2005;5(1):5-13.
  • Banu KY, Niyazi OD, Erdem C, Dpekci Afsin DH, Ozlem U, Yasemin C, et al. Value of heart-type fatty acid-binding protein (H-FABP) for emergency department patients with suspected acute coronary syndrome. African health sciences. 2014;14(3):757-62.
  • Bonow RO, Masoudi FA, Rumsfeld JS, DeLong E, Estes NAM, Goff DC, et al. ACC/AHA classification of care metrics: performance measures and quality metrics: a report of the American College of Cardiology/American Heart Association Task Force on Performance Measures. Journal of the American College of Cardiology. 2008;52(24):2113-7.
  • Khursheed M, Fayyaz J, Feroze A, Shakeel N, Bhatti JA. Time to treatment in patients of suspected acute coronary syndrome in Pakistan: A clinical audit. Heart & lung : the journal of critical care. 2015;44(1):63-7.
  • Wu AH, Apple FS, Gibler WB, Jesse RL, Warshaw MM, Valdes R, Jr. National Academy of Clinical Biochemistry Standards of Laboratory Practice: recommendations for the use of cardiac markers in coronary artery diseases. Clinical chemistry. 1999;45(7):1104-21.
  • Kelly AM, Klim S, Soon K. External validation of the GRACE Freedom from Events score in an emergency department 'rule out ACS' chest pain cohort. International journal of cardiology. 2015;179:358-9.
  • Collinson PO, Premachandram S, Hashemi K. Prospective audit of incidence of prognostically important myocardial damage in patients discharged from emergency department. Bmj. 2000;320(7251):1702-5.
  • Tintinalli JE, Stapczynski JS. Tintinalli's emergency medicine: a comprehensive study guide: McGraw-Hill New York; 2011.
  • Schneider SM, Cobaugh DJ, Leahey NF. Gatekeepers: a missed opportunity for safe transport. Academic emergency medicine : official journal of the Society for Academic Emergency Medicine. 1998;5(6):587-92.
  • Noorani MM, Khaliq MF, Shoaib M, Sheikh A, Moughal UE, Moazzum W, et al. Time intervals and associated factors of emergency treatment: first insight into Pakistani system. International archives of medicine. 2014;7(1):41.
  • Özen M, Serinken M, Yilmaz A, Özen Ş. Acil Servise Başvuran Akut Koroner Sendrom Tanılı Hastaların Sosyodemografik ve Klinik Özellikleri. Turkish Journal of Emergency Medicine. 2012;12(3).
  • Karlson BW, Wiklund I, Bengston A, Herlitz J. Prognosis and symptoms one year after discharge from the emergency department in patients with acute chest pain. Chest. 1994;105(5):1442-7.
  • Solinas L, Raucci R, Terrazzino S, Moscariello F, Pertoldi F, Vajto S, et al. Prevalence, clinical characteristics, resource utilization and outcome of patients with acute chest pain in the emergency department. A multicenter, prospective, observational study in north-eastern Italy. Italian heart journal : official journal of the Italian Federation of Cardiology. 2003;4(5):318-24.
  • Hahne K, Lebiedz P, Breuckmann F. Impact of d-Dimers on the Differential Diagnosis of Acute Chest Pain: Current Aspects Besides the Widely Known. Clinical Medicine Insights Cardiology. 2014;8(Suppl 2):1-4.
  • Ceylan Y, Kaya Y, Tuncer M. Akut Koroner Sendrom Kliniği ile Başvuran Hastalarda Koroner Arter Hastalığı Risk Faktörleri. Van Tıp Dergisi. 2011;18(3):147-54.
  • Liu N, Lee MA, Ho AF, Haaland B, Fook-Chong S, Koh ZX, et al. Risk stratification for prediction of adverse coronary events in emergency department chest pain patients with a machine learning score compared with the TIMI score. International journal of cardiology. 2014;177(3):1095-7.
  • Dedeoğlu E, Topaçoğlu H. The Relation Between The Intensity Of Chest Pain Of The People Who Applied To Emergency Room With Their Chest Pain Complaints With St Segment Changes And Acute Coronary Syndrome. Tr J Emerg Med}.11:99-103.
  • Koukkunen H, Pyörälä K, Halinen MO. Low-risk patients with chest pain and without evidence of myocardial infarction may be safely discharged from emergency department. European heart journal. 2004;25(4):329-34.
There are 23 citations in total.

Details

Subjects Health Care Administration
Journal Section Original Research
Authors

Nurşah Başol

Gülşen Çığşar

Eray Atalay

Serpil Can This is me

Elnare Günal

Mehmet Tamer Özdemir

Özcan Keskin

Publication Date February 26, 2016
Published in Issue Year 2016 Volume: 6 Issue: 1

Cite

APA Başol, N., Çığşar, G., Atalay, E., Can, S., et al. (2016). The Role of Emergency Physicians on the Management of Chest Pain. Çağdaş Tıp Dergisi, 6(1), 30-34. https://doi.org/10.16899/ctd.34656
AMA Başol N, Çığşar G, Atalay E, Can S, Günal E, Özdemir MT, Keskin Ö. The Role of Emergency Physicians on the Management of Chest Pain. J Contemp Med. February 2016;6(1):30-34. doi:10.16899/ctd.34656
Chicago Başol, Nurşah, Gülşen Çığşar, Eray Atalay, Serpil Can, Elnare Günal, Mehmet Tamer Özdemir, and Özcan Keskin. “The Role of Emergency Physicians on the Management of Chest Pain”. Çağdaş Tıp Dergisi 6, no. 1 (February 2016): 30-34. https://doi.org/10.16899/ctd.34656.
EndNote Başol N, Çığşar G, Atalay E, Can S, Günal E, Özdemir MT, Keskin Ö (February 1, 2016) The Role of Emergency Physicians on the Management of Chest Pain. Çağdaş Tıp Dergisi 6 1 30–34.
IEEE N. Başol, G. Çığşar, E. Atalay, S. Can, E. Günal, M. T. Özdemir, and Ö. Keskin, “The Role of Emergency Physicians on the Management of Chest Pain”, J Contemp Med, vol. 6, no. 1, pp. 30–34, 2016, doi: 10.16899/ctd.34656.
ISNAD Başol, Nurşah et al. “The Role of Emergency Physicians on the Management of Chest Pain”. Çağdaş Tıp Dergisi 6/1 (February 2016), 30-34. https://doi.org/10.16899/ctd.34656.
JAMA Başol N, Çığşar G, Atalay E, Can S, Günal E, Özdemir MT, Keskin Ö. The Role of Emergency Physicians on the Management of Chest Pain. J Contemp Med. 2016;6:30–34.
MLA Başol, Nurşah et al. “The Role of Emergency Physicians on the Management of Chest Pain”. Çağdaş Tıp Dergisi, vol. 6, no. 1, 2016, pp. 30-34, doi:10.16899/ctd.34656.
Vancouver Başol N, Çığşar G, Atalay E, Can S, Günal E, Özdemir MT, Keskin Ö. The Role of Emergency Physicians on the Management of Chest Pain. J Contemp Med. 2016;6(1):30-4.