In the ninth part of our emergency series, Sandeep Ghandi, Richard Marshall, Hugh Montgomery, David Howell, and Neil Goldsack tell you how to assess and treat patients who present with chest pain
Chest pain is one of the most common medical presentations to the emergency department. The importance of assessing patients with chest pain is to identify those patients with a high short term risk of mortality or morbidit and to instigate life saving treatment.
In the first of two articles on chest pain, we shall discuss the diagnosis and management of acute coronary events.
A detailed history, problem oriented examination, and electrocardiogram are the most important tools in reaching a diagnosis. The traditional approach of history, examination, investigations, and treatment must, however, be tempered by the clinical urgency of the situation. For example, when you are dealing with a patient with an acute myocardial infarction you will see the electrocardiogram first and start treatment before completing a full history and examination--more on this important concept later.
When you are called to see a patient with chest pain you should ascertain basic