July 1, 2013The Medical Journal of Australia
The approach to patients with possible cardiac chest pain
Key result
An integrated approach using clinical risk stratification, high-sensitivity cardiac biomarkers, and non-invasive testing is required to safely assess patients with possible cardiac chest pain.
Population
Patients presenting with possible cardiac chest pain to emergency departments and general practice
Design
Review
Authors
Discussion
Loading...
Member takes
Implication
May guide current chest pain pathways; leaves open the need for prospective validation.
Structured PICO
P
Population
Patients presenting with possible cardiac chest pain to emergency departments and general practice
I
Intervention
Integrated clinical approach including 12-lead electrocardiogram, risk stratification, sensitive cardiac biomarkers, and non-invasive tests
An integrated clinical approach using risk stratification, sensitive biomarkers, and non-invasive testing is recommended for safely and effectively evaluating patients with possible cardiac chest pain.
Limitations
- Clinical assessment alone is insufficient to safely rule out coronary artery disease.
- High-sensitivity troponin assays offer earlier rule-out of myocardial infarction but with probable diminished specificity.
- Computed tomography coronary angiography (CTCA) is limited by elevated heart rate, coronary calcium, obesity, and radiation exposure.
Cite This Study
Parsonage et al. (2013) conducted a review in Cardiac chest pain. Chest pain assessment strategies was evaluated. An integrated approach using clinical risk stratification, high-sensitivity cardiac biomarkers, and non-invasive testing is required to safely assess patients with possible cardiac chest pain.