Key result
Chest pain in emergency clinics has diverse causes, and its mode of onset and modifying factors are more important diagnostic clues than its duration or quality.
Highlights the importance of evaluating the mode of onset and inciting or relieving factors when assessing chest pain in emergency settings.
Emphasizes onset and modifiers in emergency chest pain assessment; leaves open prospective validation in contemporary cohorts.
CAUSES of chest pain are diverse and numerous. The chest contains many structures. Not only can disease of any of these structures produce pain in the chest, but also pain originating elsewhere in the body, particularly in the gastrointestinal tract, may be referred to the chest. Longlasting pain or brief episodes of chest discomfort are the two patterns of pain that usually cause emergency clinic visits. Either pattern may be caused by benign or life-threatening conditions, but persistent severe pain, particularly if associated with objective evidence of disease, such as fever, tachycardia, or the appearance of shock, points toward a serious organic condition. Much more important than the duration of the pain or even its quality are its mode of onset and factors that incite, affect, or relieve it. Although radiation of the pain to the left arm is frequently considered by both patient and physician as particularly ominous and
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Robert E. Kleiger (1976) conducted a review in Chest pain. Chest pain in emergency clinics has diverse causes, and its mode of onset and modifying factors are more important diagnostic clues than its duration or quality.
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