Chest Pain in Repeated Emergency Department Visitors

Abstract

Chest pain is the leading symptom in 5 to 8% of all emergency department (ED) visits [1-3] and is also one of the major reasons of repeated ED visits, causing around 6% of these cases [1]. Generally, in 15 to 25% of patients with chest pain, acute myocardial infarction (AMI) is the underlying cause [4-6]. International literature describes an all-population based, one-month mortality rate of AMI between 8 to 24% [7,8] and an all-population based, one-year mortality rate of 19% [9]. Therefore, AMI has to be diagnosed or ruled out quickly. For this purpose, a fast clinical assessment including cardiac biomarker testing and the rapid execution of an electrocardiogram (ECG) are necessary. Based on the leading symptoms and clinical presentation, ECG-findings and in combination Abstract