Evaluation of acute chest pain: Evolving paradigm of coronary risk scores and imaging

Alderwish, Edris; Schultz, Emily; Kassam, Zain; Poon, Michael; Coplan, Neil L.

doi:10.31083/j.rcm.2019.04.589

Cited by 14 publications

(5 citation statements)

References 99 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…12,13 About 5.1-6% of patients reporting to Emergency department with chest pain have Acute Coronary Syndrome whereas most of these patients presenting to ED have a non-cardiac cause of chest pain. 14,15 Psychological mechanisms have an integral role in non-cardiac chest pain. 16 Study carried out in Iran in 2016 by Mousavi depicted that mean age of patients reporting to ED with non-cardiac chest pain was 26.33±5.77 years and females accounted for majority of these participants 148(65.5%).…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Anxiety and Depression in Young Patients Presenting with Atypical Chest Pain with Normal Coronaries

Ahmed,

Mehreen,

Samore

et al. 2023

PAFMJ

View full text Add to dashboard Cite

Objective: To determine the prevalence of anxiety and depression in young patients presenting with atypical chest pain andnormal coronary arteries. Study Design: Analytical, Cross-Sectional Study. Place and Duration of Study: Armed Forces Institute of Cardiology/National Institute of Heart Diseases Rawalpindi,Pakistan, from Jul to Dec 2021. Methodology: This study was carried out on 750 participants (having normal coronaries) of both gender and age<40yearsdivided into study group (presented with atypical chest pain; n=375) and comparison group (no chest pain; n=375). Consecutive sampling technique was applied to collect data. Hospital Anxiety and Depression Scale (HADS) Questionnairewas used. Patients scoring 11 or more out of 21 points in Depression and Anxiety scale were identified as positive. Data was analyzed using SPSS version 24:00. Chi Square test was applied to find association between variables and p-value <0.05 wastaken as significant value. Results: Out of n=750 patients 619(82.4%) were males and 131(17.6%) were females. Mean age at presentation was 33.54±5.54 years and 30.93±5.68 years in study and comparison group respectively. About 230(61.3%) participants had anxiety in the study group compared with 189(50.4%) in the comparison group, which was statistically significant (p=0.003). 221(58.9%) participants in study group and 132(35.2%) in comparison group had depression (p<0.001). Conclusion: Non cardiac chest pain is a common manifestation of depression and anxiety. Early recognition and prompt referral of these patients should be ensured to improve quality of life and prevent future unnecessary hospital visits.

show abstract

Section: Discussionmentioning

confidence: 99%

Prevalence of Anxiety and Depression in Young Patients Presenting with Atypical Chest Pain with Normal Coronaries

Ahmed,

Mehreen,

Samore

et al. 2023

PAFMJ

View full text Add to dashboard Cite

show abstract

“…Acute chest pain is one of the more dangerous diseases in the emergency department and is a pain that occurs in the chest or radiates from other parts of the body to the chest [ 13 ]. The causes of acute chest pain are many and involve multiple organs and systems, commonly including chest boils and carbuncles, herpes zoster, trauma, pneumothorax, myocarditis, and abdominal diseases [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

Predictive Value of the HEART Score Combined with Hypersensitive C-Reactive Protein for 30 d Adverse Cardiovascular Events in Patients with Acute Chest Pain

Lin

Zhang

Tang

et al. 2022

Emergency Medicine International

View full text Add to dashboard Cite

Purpose. This study aimed to explore the predictive value of the HEART score combined with hypersensitive C-reactive protein (hs-CRP) for 30 d major adverse cardiovascular events (MACEs) in patients with acute chest pain. Methods. 103 patients with acute chest pain admitted to the emergency department of our hospital from May 2020 to May 2022 were selected as the study subjects. The patients’ HEART score and plasma hs-CRP level were recorded. The patients were followed up for 30 d to observe whether MACE occurred. Results. Among 103 patients with acute chest pain, MACE occurred in 8 cases within 30 d of follow-up, and the probability of MACE was 7.76%. There was a statistically significant difference in 30 d MACE risk among patients with different HEART score stratification ( P < 0.05 ). The age, HEART score, and hs-CRP levels of patients in the MACE group were higher than those in the non-MACE group ( P < 0.05 ). The HEART score and the hs-CRP level were independent risk factors for 30 d MACE in patients with acute chest pain ( P < 0.05 ). The AUC of the HEART score combined with hs-CRP in the occurrence of 30 d MACE in patients with acute chest pain was 0.901, which was significantly higher than 0.720 and 0.758 of single detection. Conclusion. The HEART score combined with hs-CRP can better predict the occurrence of 30 d MACE in patients with acute chest pain.

show abstract

“…The efficacy of a scoring system can be estimated by its capacity to identify patients at a significantly low risk of developing major adverse cardiovascular events (MACE) or mortality during the follow-up period [ 4 ]. Classically, the Thrombolysis In Myocardial Infarction (TIMI) and Global Registry of Acute Coronary Events (GRACE) criteria have been implemented for the purpose of risk computation in such cases [ 5 , 6 ]. The overall sensitivity of TIMI in identifying the low-risk cohort approximates 97% whereas GRACE holds a sensitivity of 94% in terms of estimating the all-cause mortality among patients with a clinical suspicion of IHD.…”

Section: Introductionmentioning

confidence: 99%

Risk Stratification of Acute-Onset Chest Pain: SVEAT Score Versus HEART and TIMI Scores

Shahid¹,

Malik²,

Kashif³

et al. 2023

Cureus

View full text Add to dashboard Cite

IntroductionAcute chest pain is a frequently encountered symptom in the emergency department. Despite the availability of various chest pain risk scores, their effectiveness in identifying low-risk patients suitable for safe and early discharge is inadequate. Moreover, clinical data collected at the initial stage, which has valuable discriminatory ability, is often underutilized. This study aims to assess the effectiveness of the Symptoms, history of Vascular disease, ECG, Age, and Troponin I (SVEAT) score in predicting major adverse cardiovascular events (MACE) in acute-onset chest pain, compared with the pre-existing History, ECG, Age, Risk factors, and Troponin I (HEART) and Thrombolysis In Myocardial Infarction (TIMI) scores. MethodologyThis prospective study utilizing non-probability convenience sampling was conducted in the emergency medicine department of a tertiary care hospital in Rawalpindi, Pakistan, for a period of five months from July 2022 to November 2022. The study included patients aged >45 years who presented primarily with chest pain lasting for at least five minutes but less than 24 hours and with a lack of acute ECG changes indicative of ST-elevation acute coronary syndrome (STE-ACS). Patients who were hemodynamically unstable were excluded. All patients were assessed for the calculation of SVEAT, TIMI, and HEART scores. All patients were followed for a period of 30 days to assess the incidence of MACE. ResultsA total of 60 patients were included. The mean age was 61.5±9.1 years while 31 (51.7%) patients were females. Diabetes was the most prevalent comorbidity (n=32; 53.3%). Regarding MACE, nine (15%) patients developed ACS and underwent percutaneous coronary intervention (PCI). Two patients (3.3%) experienced heart failure. Six (10%) patients also underwent PCI in the absence of ACS while two (3.3%) patients developed sudden cardiac death. Area-under-curve (AUC) values were determined for SVEAT (0.843; 95%CI: 0.74-0.94), TIMI (0.742; 95%CI: 0.62-0.86), and HEART scores (0.840; 95%CI: 0.74-0.94). A cut-off level of 3.5 SVEAT points obtained a sensitivity of 63.2% and specificity of 75.6% in predicting 30-day MACE. ConclusionSVEAT score potentially lacks the appropriate sensitivity level to predict a significant number of major adverse cardiovascular events compared to contemporary risk stratification scores. Therefore, the SVEAT criteria need re-evaluation as a screening tool for risk assessment in acute chest pain.

show abstract

Evaluation of acute chest pain: Evolving paradigm of coronary risk scores and imaging

Cited by 14 publications

References 99 publications

Prevalence of Anxiety and Depression in Young Patients Presenting with Atypical Chest Pain with Normal Coronaries

Prevalence of Anxiety and Depression in Young Patients Presenting with Atypical Chest Pain with Normal Coronaries

Predictive Value of the HEART Score Combined with Hypersensitive C-Reactive Protein for 30 d Adverse Cardiovascular Events in Patients with Acute Chest Pain

Risk Stratification of Acute-Onset Chest Pain: SVEAT Score Versus HEART and TIMI Scores

Contact Info

Product

Resources

About