Although most chest pain in primary care is benign, a significant minority (8.4%) involves life-threatening causes, justifying the high rate of diagnostic testing and referrals.
Chest pain was present in 281 patients (1.26% of all consultations). Final diagnoses were mostly non-life-threatening. Nevertheless, in 8.4% of patients with chest pain, life-threatening underlying causes were identified. This seems reflected in the magnitude and wide variety of diagnostic tests performed in these patients by GPs and specialists, in the (safe) overestimation of life-threatening diseases by GPs at initial assessment and in the high referral rate we found.
Hoorweg et al. (Tue,) studied this question.