2012
DOI: 10.3325/cmj.2012.53.432
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Does the patient with chest pain have a coronary heart disease? Diagnostic value of single symptoms and signs – a meta-analysis

Abstract: AimTo determine the diagnostic value of single symptoms and signs for coronary heart disease (CHD) in patients with chest pain.MethodsSearches of two electronic databases (EMBASE 1980 to March 2008, PubMed 1970 to May 2009) and hand searching in seven journals were conducted. Eligible studies recruited patients presenting with acute or chronic chest pain. The target disease was CHD, with no restrictions regarding case definitions, eg, stable CHD, acute coronary syndrome (ACS), acute myocardial infarction (MI),… Show more

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Cited by 37 publications
(27 citation statements)
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“…Although the studied symptoms are not necessarily logical predictors of cardiovascular disease, several previous studies have shown that headaches are suggestive of an incremental risk of stroke, 34 35 and other studies have also shown that vertigo or dizziness and chest pain are associated with cardiovascular problems. 36 37 We also conducted an analysis on a subsample of individuals' self-reported information, which suggested that all of the discussed symptoms were associated with a diagnosis of hypertension in the previous year, and that exacerbation of dizziness, palpitations and shortness of breath were associated with a diagnosis of heart disease in the last year (data not shown). Therefore, our study of these four symptoms may be helpful for developing plans to improve evacuees' health to some extent.…”
Section: Discussionmentioning
confidence: 99%
“…Although the studied symptoms are not necessarily logical predictors of cardiovascular disease, several previous studies have shown that headaches are suggestive of an incremental risk of stroke, 34 35 and other studies have also shown that vertigo or dizziness and chest pain are associated with cardiovascular problems. 36 37 We also conducted an analysis on a subsample of individuals' self-reported information, which suggested that all of the discussed symptoms were associated with a diagnosis of hypertension in the previous year, and that exacerbation of dizziness, palpitations and shortness of breath were associated with a diagnosis of heart disease in the last year (data not shown). Therefore, our study of these four symptoms may be helpful for developing plans to improve evacuees' health to some extent.…”
Section: Discussionmentioning
confidence: 99%
“…Important first steps in the evaluation of patients with chest pain are the history and physical examination. 1 Clinicians can identify patients in need of further investigations with a thorough history and physical examination, helping to protect patients from potentially harmful and unnecessary testing while minimizing health care expenses. In primary contact settings, such as the chiropractic clinic, the history and physical examination remain the practitioner's main diagnostic tools.…”
Section: Discussionmentioning
confidence: 99%
“…1 A medical history of diabetes mellitus, dyslipidemia, hypertension, previous coronary artery disease, myocardial infarction, and angina pectoris, and a family history of heart disease are additional classical risk factors. 1,18 Other symptoms that may be associated with chest pain include diaphoresis, dyspnea, nausea/ vomiting, dizziness, syncope or collapse, palpitation, weakness, fear, and anxiety. 16 Physical signs that are indicative of cardiovascular disease and that are measurable in a clinical setting include elevated blood pressure, tachycardia, bradycardia, and rales.…”
Section: Discussionmentioning
confidence: 99%
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