Chest pain in daily practice: occurrence, causes and management

Details

Ressource 1Download: 18561039.pdf (183.81 [Ko])
State: Public
Version: Final published version
Serval ID
serval:BIB_B672539CBDE0
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Chest pain in daily practice: occurrence, causes and management
Journal
Swiss Medical Weekly
Author(s)
Verdon F., Herzig L., Burnand B., Bischoff T., Pécoud A., Junod M., Mühlemann N., Favrat B.
ISSN
1424-7860
Publication state
Published
Issued date
2008
Peer-reviewed
Oui
Volume
138
Number
23-24
Pages
340-347
Language
english
Notes
[Texte intégral] http://www.smw.ch/docs/pdf200x/2008/23/smw-12123.PDF
Abstract
QUESTIONS UNDER STUDY: We assessed the occurrence and aetiology of chest pain in primary care practice. These features differ between primary and emergency care settings, where most previous studies have been performed. METHODS: 59 GPs in western Switzerland recorded all consecutive cases presenting with chest pain. Clinical characteristics, laboratory tests and other investigations as well as the diagnoses remaining after 12 months of follow-up were systematically registered. RESULTS: Among 24,620 patients examined during a total duration of 300 weeks of observation, 672 (2.7%) presented with chest pain (52% female, mean age 55 +/- 19(SD)). Most cases, 442 (1.8%), presented new symptoms and in 356 (1.4%) it was the reason for consulting. Over 40 ailments were diagnosed: musculoskeletal chest pain (including chest wall syndrome) (49%), cardiovascular (16%), psychogenic (11%), respiratory (10%), digestive (8%), miscellaneous (2%) and without diagnosis (3%). The three most prevalent diseases were: chest wall syndrome (43%), coronary artery disease (12%) and anxiety (7%). Unstable angina (6), myocardial infarction (4) and pulmonary embolism (2) were uncommon (1.8%). Potentially serious conditions including cardiac, respiratory and neoplasic diseases accounted for 20% of cases. A large number of laboratory tests (42%), referral to a specialist (16%) or hospitalisation (5%) were performed. Twentyfive patients died during follow-up, of which twelve were for a reason directly associated with thoracic pain [cancer (7) and cardiac causes (5)]. CONCLUSIONS: Thoracic pain was present in 2.7% of primary care consultations. Chest wall syndrome pain was the main aetiology. Cardio - vascular emergencies were uncommon. However chest pain deserves full consideration because of the occurrence of potentially serious conditions.
Keywords
Adult, Aged, Chest Pain, Female, Humans, Incidence, Male, Middle Aged, Primary Health Care, Prospective Studies
Pubmed
Web of science
Create date
22/01/2009 13:41
Last modification date
20/08/2019 15:24
Usage data