The role of the emergency department in the management of patients with atypical chest pain

There is often an inconsistent approach to the management of patients with chest pain which is not due to myocardial infarction. The stratification of risk groups, utility of diagnostic tests and current practice in the USA are discussed. Recommendations for a change in our current practice are: Patients with unstable angina, acute myocardial infarction and those with a high suspicion of acute myocardial infarction should be admitted to hospital. Those patients with atypical chest pain should be considered for early exercise testing in or from the emergency department. In the absence of the facility for exercise testing in or from the emergency department, patients with atypical chest pain should be admitted to hospital.