| Abstract [eng] |
The aim of this paper is to review the recent literature on chest pain in the emergency department. The paper analyses different risk assessment and diagnostic methods for the etiology of chest pain and tests that can help in the selection of patients with life-threatening conditions, focusing on acute coronary syndromes with an emphasis on myocardial infarction. The literature review was performed using the PubMed search engine in the Medline electronic database, with an emphasis on the literature of the last five years. Chest pain is one of the most common complaints in the emergency department. As most patients will eventually be diagnosed with non-serious conditions, the main challenge is to quickly identify the small number of patients with life-threatening conditions, one of the main being acute coronary syndrome. Symptoms and physical examination can help to identify the cause – this paper discussed the signs that are characteristic for acute coronary syndrome. Risk stratification for chest pain usually starts with a 12-lead electrocardiogram, as it is used as the main instrumental test for detecting myocardial ischemia. Of the laboratory test, the most important is the serial measurement of high-sensitivity cardiac troponins: the evaluation of this marker of myocardial injury allows early risk stratification of patients with suspected acute coronary syndrome. This paper also discusses scoring scales which help clinicians objectively assess the risk of heart disease-related morbidity and mortality in chest patients. |
