Key result
Neck radiation in chest pain linked to ~12.4-fold higher odds of cardiac diagnosis.
Why the study?
Non-traumatic chest pain encompasses both life-threatening cardiovascular diseases and non-cardiac etiologies, yet evidence describing its clinical distribution, associated factors, and early emergency outcomes in Somalia is limited.
Cross-Sectional (n=310)
No
Answers are grounded in this paper and cite their sources.
In a tertiary PCI-capable emergency department in Somalia, acute coronary syndrome accounted for roughly one-third of non-traumatic chest pain presentations, with traditional clinical features strongly associated with cardiac etiologies.
Background Non-traumatic chest pain spans immediately life-threatening cardiovascular diseases and several non-cardiac etiologies. Evidence describing the clinical distribution and early outcomes of chest pain in Somalia is limited. We examined diagnoses, associated factors, and emergency department (ED) disposition at a tertiary referral hospital with PCI and CABG capabilities. Methods This prospective, cross-sectional analytical study consecutively enrolled 310 consenting adults with non-traumatic chest pain from April 2024 to April 2026. Variables were captured prospectively using Google Forms and analysed descriptively and with Pearson chi-square testing and multivariable binary logistic regression. The study-defined cardiac group included ACS, supraventricular tachycardia, pericarditis, aortic dissection, stable angina, and a combined pulmonary edema/ARDS category. Results are presented as adjusted odds ratios (aOR) with 95% confidence intervals (CI). Results Mean age was 53.7 ± 19.1 years, and 208/310 (67.1%) were male. Cardiac-group diagnoses accounted for 159/310 (51.3%); ACS was the leading diagnosis (106/310; 34.2%). Independent adjusted associations with the cardiac group were age per decade (aOR 1.35, 95% CI 1.07–1.70), sudden onset (3.70, 1.67–8.19), central/left-sided location (8.55, 2.74–26.67), arm radiation (10.37, 1.73–62.16), and neck radiation (12.43, 2.10–73.63). Sixteen patients (5.2%) died in the ED, and 45 (14.5%) were discharged against medical advice. The 17 cases coded as pulmonary edema/ARDS could not be etiologically separated. Conclusion ACS represented about one-third of non-traumatic chest-pain presentations in this selected tertiary ED. Clinical features were strongly associated with the study-defined cardiac diagnostic grouping, but imprecise estimates and diagnosis-recording limitations preclude use as a stand-alone prediction rule. Standardized testing and improved emergency care pathways merit prospective evaluation.
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Ali et al. (2026) conducted a cross-sectional in Non-traumatic chest pain (n=310). Clinical features of chest pain (e.g., neck radiation) vs. Absence of high-risk clinical features was evaluated on Study-defined cardiac group diagnosis (ACS, supraventricular tachycardia, pericarditis, aortic dissection, stable angina, or pulmonary edema/ARDS) (OR 12.43, 95% CI 2.10-73.63). Non-traumatic chest pain presentations had a 51.3% cardiac etiology, with neck radiation strongly associated with cardiac diagnosis.
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