Outcome from a rapid-assessment chest pain clinic

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. Genera...

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Bibliographic Details
Published in:QJM : An International Journal of Medicine 1998-05, Vol.91 (5), p.339-343
Main Authors: DAVIE, A. P, CAESAR, D, CARUANA, L, CLEGG, G, SPILLER, J, CAPEWELL, S, STARKEY, I. R, SHAW, T. R. D, MCMURRAY, J. J. V
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Biological and medical sciences
Cardiology. Vascular system
Chest Pain - etiology
Chest Pain - therapy
Coronary Disease - diagnosis
Coronary Disease - therapy
Coronary heart disease
Female
Follow-Up Studies
Heart
Hospitals, Public
Humans
Male
Medical Audit
Medical sciences
Middle Aged
Outcome Assessment (Health Care)
Pain Clinics - statistics & numerical data
Patient Satisfaction
Scotland
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Summary: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.
ISSN:1460-2725
1460-2393
DOI:10.1093/qjmed/91.5.339