The diagnoses of patients admitted with acute chest pain but without myocardial infarction

Fruergaard, P; Launbjerg, J; Hesse, Birger; Jørgensen, F; Petri, Anette Lykke; Eiken, Patrick W.; Aggestrup, S; Elsborg, L; Mellemgaard, Kresten

doi:10.1093/oxfordjournals.eurheartj.a014998

Cited by 128 publications

(76 citation statements)

References 22 publications

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“…Previous studies that investigated patients with non-cardiac chest pain in secondary care using oesophageal endoscopy and pH monitoring have reported the oesophagus to be a potential origin of non-cardiac chest pain in up to two-thirds of patients, with GORD being the most likely cause. [18][19][20][21] A study in UK primary care reported that IHD was ruled out in half of all patients consulting with chest pain, and that the chest pain had an oesophageal origin in 10% of patients. 22 Similarly, in this study it was found that 10% of patients with non-specific chest pain reported gastrointestinal complaints such as GORD, dyspepsia, or peptic disease during the year preceding the index date, and that 3% of patients with non-specific chest pain had previously received a GORD diagnosis.…”

Section: Comparison With Existing Literaturementioning

confidence: 99%

Chest pain without established ischaemic heart disease in primary care patients: associated comorbidities and mortality

Ruigómez¹,

Massó-González²,

Johansson³

et al. 2009

Br J Gen Pract

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Section: Comparison With Existing Literaturementioning

confidence: 99%

Chest pain without established ischaemic heart disease in primary care patients: associated comorbidities and mortality

Ruigómez¹,

Massó-González²,

Johansson³

et al. 2009

Br J Gen Pract

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“…However, clinical symptoms may be vague, opening a broad differential diagnosis including pneumothorax, acute aortic or coronary syndromes, musculoskeletal and gastrointestinal disorders, and psychiatric conditions. Esophageal diseases are a common cause of chest discomfort and occur in more than one third of patients with excluded acute coronary syndrome (5). Daily reflux symptoms are reported in 4 to 7% of the population and about 2% suffer from esophagitis (6).…”

Section: Introductionmentioning

confidence: 99%

The Additional Value of Esophageal Wall Evaluation and Secondary Findings in Emergency Patients Undergoing CT Pulmonary Angiography

et al. 2017

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Background: A significant proportion of patients with chest discomfort suffer from esophageal pathology and other conditions unrelated to pulmonary embolism. Objectives: To determine the proportion of emergency patients undergoing CT pulmonary angiography, where esophageal pathology suspected from CT and other secondary findings would contribute to the explanation of their symptoms. Patients and Methods: CT scans of 434 patients who were referred from the emergency department for CT pulmonary angiography were evaluated for esophageal wall thickness and distention, the presence of pulmonary embolism and other findings that might explain acute symptoms. Esophageal pathology was considered when the distal esophageal wall was at least 5 mm thick, as previously reported. Results: Pulmonary embolism was confirmed in 27% patients. The distal esophageal wall was thickened in 87 (20%) patients. In this group, pulmonary embolism was present in 11 patients (13%) compared to 104 (30%) in patients without esophageal wall thickening (P = 0.007). From 76 patients with excluded pulmonary embolism, in 43 (56%), a suspected esophageal pathology was consistent with their symptoms. Gastroscopy confirmed CT findings in 34 of 42 patients (P = 0.0001). Conclusion: Esophageal wall thickening is common in emergency patients with excluded pulmonary embolism and this finding may help to direct the patients appropriately.

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“…Another 50% of acute chest pain admissions are for non-cardiac-related reasons 7 ; and in acute chest pain clinics, musculoskeletal chest pain accounts for between 5% and 20% of total visits. [8][9][10] Chest pain of a serious cardiovascular concern, for example, myocardial infarction and acute coronary syndrome, is seen less often in the primary care setting than in the emergency care setting. 11 Chest pain presentations in chiropractic clinics may be of a musculoskeletal origin.…”

Section: Introductionmentioning

confidence: 99%

Presentation of Coronary Artery Disease in a Chiropractic Clinic: A Report of 2 Cases

Larson¹

2016

Journal of Chiropractic Medicine

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Objective: The purpose of this report is to describe 2 patients with coronary artery disease presenting with musculoskeletal symptoms to a chiropractic clinic. Clinical Features: A 48-year-old male new patient had thoracic spine pain aggravated by physical exertion. A 61-year-old man under routine care for low back pain experienced a secondary complaint of acute chest pain during a reevaluation. Intervention and Outcome: In both cases, the patients were strongly encouraged to consult their medical physician and were subsequently diagnosed with coronary artery disease. Following their diagnoses, each patient underwent surgical angioplasty procedures with stenting. Conclusion: Patients may present for chiropractic care with what appears to be musculoskeletal chest pain when the pain may be generating from coronary artery disease necessitating medical and possibly emergency care.

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The diagnoses of patients admitted with acute chest pain but without myocardial infarction

Cited by 128 publications

References 22 publications

Chest pain without established ischaemic heart disease in primary care patients: associated comorbidities and mortality

Chest pain without established ischaemic heart disease in primary care patients: associated comorbidities and mortality

The Additional Value of Esophageal Wall Evaluation and Secondary Findings in Emergency Patients Undergoing CT Pulmonary Angiography

Presentation of Coronary Artery Disease in a Chiropractic Clinic: A Report of 2 Cases

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