Key result
Among emergency department attendances, 58.7% of all non-cardiac diagnoses (anxiety, panic, and chest pain of unknown cause) followed an initial presentation with chest pain.
Cross-Sectional (n=180,409)
No
p-value: p=<0.001
A significant proportion (nearly 60%) of emergency department presentations for chest pain result in a non-cardiac diagnosis, highlighting the need for appropriate psychological screening and management pathways.
Supports consideration of psychological screening in ED chest pain pathways; leaves open impact on outcomes and need for interventional trials.
BACKGROUND: The aim of this study was to assess the frequency of chest pain presentations and the subsequent non-cardiac chest pain diagnoses in an emergency department (ED) over a 3 year period. METHODS: Administrative data on ED attendances to an urban general hospital in Northern Ireland between March 2013 and March 2016 were used. Data were coded and analysed to estimate frequencies of 'chest pain' presentation and the subsequent diagnoses for each year. RESULTS: Both chest pain presentations and chest pain presentations with a subsequent diagnosis of unknown cause increased each year. In total, 58.7% of all chest presentations across 3 years resulted in a non-cardiac diagnosis of either 'anxiety', 'panic' or 'chest pain of unknown cause'. DISCUSSION: There is a significant amount of patients in the ED leaving with a non-cardiac diagnosis, following an initial presentation with chest pain. CONCLUSION: Given the link between non-cardiac chest pain and frequent use of services, the degree of repeat attendance should be investigated.
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McDevitt‐Petrovic et al. (2017) conducted a cross-sectional in Chest pain (n=180,409). Chest pain presentation vs. Non-chest pain presentation was evaluated on Non-cardiac diagnosis (anxiety, panic, or chest pain of unknown cause) (p=<0.001). Among emergency department attendances, 58.7% of all non-cardiac diagnoses (anxiety, panic, and chest pain of unknown cause) followed an initial presentation with chest pain.
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