Outcome from a rapid-assessment chest pain clinic

Davie, A.P., Caesar, D., Caruana, L., Clegg, G., Spiller, J., Capewell, S., Starkey, I.R., Shaw, T.R. and McMurray, J.J.V. (1998) Outcome from a rapid-assessment chest pain clinic. QJM: An International Journal of Medicine, 91(5), pp. 339-343. (doi: 10.1093/qjmed/91.5.339) (PMID:9709467)

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Abstract

Chest pain accounts for much of the rising numbers of emergency admissions, but in-patient assessment is not necessarily the best way of dealing with these patients. We ran a 'rapid-assessment chest pain clinic' to provide an alternative route of assessment, and audited its outcome. General practitioners referred patients with recent-onset chest pain, increasing chest pain, chest pain at rest, or other chest pain of concern, on the understanding that they would be seen within 24 h. During 8 1/2 months, 334 patients were referred and 317 patients were seen, most of whom had exercise electrocardiography. A median of 6 months later, 278 patients were personally contacted to determine outcome. Of these, 18% had been admitted immediately with acute coronary syndromes, and 49% had been diagnosed as non-coronary chest pain (none of whom subsequently infarcted or died). Continuing symptoms were infrequent, and satisfaction was high, although 13% of patients had been revascularized. A significant number of patients required immediate admission and/or ultimate revascularization, but many more did not. The majority of these patients had non-coronary chest pain, and this diagnosis was substantiated by their excellent outcome and (in some cases) by further investigation.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Capewell, Dr Sarah and McMurray, Professor John
Authors: Davie, A.P., Caesar, D., Caruana, L., Clegg, G., Spiller, J., Capewell, S., Starkey, I.R., Shaw, T.R., and McMurray, J.J.V.
College/School:College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
Journal Name:QJM: An International Journal of Medicine
Publisher:Oxford University Press
ISSN:1460-2725
ISSN (Online):1460-2393

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