[Chest pain unit: first experience in Chile].

Abstract:

BACKGROUND:In large series, nearly 60% of admissions for suspected acute coronary syndrome (ACS) had a non-coronary etiology of the pain. However, short term mortality of non recognized ACS patients, mistakenly discharged from the emergency room is at least twice greater than the expected if they would had been admitted. The concept of a chest pain unit (CPU) is a methodological approach developed to address these issues. AIM:To evaluate the efficacy of a CPU in the emergency room of a general hospital for evaluation of acute chest pain. MATERIAL AND METHODS:Prospective study of patients with chest pain admitted in the CPU. After a clinical, electrocardiographic and laboratory evaluation with cardiac injury serum markers, patients were stratified in three risk groups, based on the likelihood of ACS of the American Heart Association. High probability patients were admitted to the Coronary Unit (CU) for treatment. Moderate probability patients remained in the CPU for further evaluation and low probability patients were discharged with telephonic follow-up. RESULTS:Of 407 patients, 35, 30 and 35% were stratified as high, intermediate and low probability ACS, respectively. Among patients admitted with high probability, 73% had a confirmed ACS diagnosis. Among intermediate probability patients, 86% were discharged after an evaluation in the CPU without adverse events in the follow-up. CONCLUSION:Structured risk evaluation approach in a CPU improves the management of acute chest pain, identifying high probability patients for fast admission and start of treatment in a CU and allowing safe discharge of low probability ones.

journal_name

Rev Med Chil

journal_title

Revista medica de Chile

authors

Castro P,Corbalán R,Isa R,Gabrielli L,Pérez O,Chamorro G,Garayar B,Baeza R,Vergara I,Godoy I,Acevedo M,Fajuri A,Fernández M,Mardones JM,Bittner A,Rodríguez JA

doi

10.4067/s0034-98872007000700003

subject

Has Abstract

pub_date

2007-07-01 00:00:00

pages

839-45

issue

7

eissn

0034-9887

issn

0717-6163

pii

S0034-98872007000700003

journal_volume

135

pub_type

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