Key result
Evaluation of atypical chest pain relies primarily on accurate history and non-invasive testing, reserving cardiac catheterization for abnormal or unclear non-invasive findings.
Why the study?
How should atypical chest pain be evaluated to identify its source?
How should atypical chest pain be evaluated to identify its source?
Atypical chest pain evaluation relies primarily on accurate history and non-invasive testing, reserving cardiac catheterization for unclear or abnormal non-invasive findings.
Answers are grounded in this paper and cite their sources.
Reinforces stepwise non-invasive evaluation to limit catheterization risks; leaves open optimal test selection in subgroups.
Atypical pain in the chest accounts for many visits to physicians. Possible sources of the pain include the pericardium, the pulmonary system, the aorta, the gastrointestinal tract, the chest wall, the mitral apparatus, and psychogenic factors. Identifying the source primarily involves taking an accurate history and understanding the prevalence of coronary artery disease in various patient populations. Electrocardiography chest films, and stress testing may help identify the source of pain. Cardiac catheterization should be reserved for patients with abnormal findings on non-invasive tests, those with unclear test results, and, rarely, as reassurance for patients with frequent episodes of atypical chest pain or their caregivers.
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Steven D. Richards (1992) conducted a review in Atypical chest pain. Evaluation of atypical chest pain relies primarily on accurate history and non-invasive testing, reserving cardiac catheterization for abnormal or unclear non-invasive findings.
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