Review

Emergency management of cardiac chest pain: a review

K R Herren, K Mackway-Jones

Department of Emergency Medicine, Accident and Emergency, Manchester Royal Infirmary Oxford Road, Manchester M13 9WL, UK

Correspondence to:
Correspondence to: Kevin Mackway-Jones, Consultant (kevin.mackway-jones@man.ac.uk)

Accepted October 5, 2000

Introduction

Chest pain accounts for 2%–4% of all new attendances at emergency departments (ED) in the United Kingdom.^{1, 2} Chest pain can be the presenting complaint in a myriad of disorders ranging from life threats such as acute myocardial infarction (AMI) to mild self limiting disorders such as muscle strain. Possible cardac chest pain can be viewed as a continuum, ranging from total global AMI to simple short lived angina. Within this spectrum lie the acute coronary syndromes with critical cardiac ischaemia and minimal myocardial damage.

Nationally over 129 000 deaths a year are attributable to ischaemic heart disease.³ AMI case mortality is currently 45% with over 70% of these dying before they reach medical care.⁴ One in eight patients with unstable angina will infarct within two weeks without appropriate treatment. In the UK around 30% of patients with chest pain are admitted and 70% discharged from the ED¹ while in the . . . [Full text of this article]

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