Evaluation of Chest Pain in the Emergency Department

Each year 5 million patients come to emergency departments with chest pain.1 Some have acute, life-threatening illness, but many others have nothing seriously wrong; some have a history of coronary disease, whereas others have never had a cardiac evaluation. The task of the physician in the emergency department is to sort out the confusing array of patients with chest pain, and to do so rapidly, accurately, and efficiently.Acute myocardial ischemia as a result of coronary atherosclerosis is the key concern in patients with chest pain. Patients with acute coronary syndromes are at considerable risk for death and serious complications, . . .