Muhammad Khurram, Hamamatul Bushra Khar, Zubair Hasan, Usmanul Haq, Mian M Arshad.
Emergency department evaluation of patients with chest pain.
J Rawal Med Coll Nov ;9(1):22-5.

Background: To note causes of chest pain in patients presenting to Medical Emergency of DHQ Teaching Hospital, Rawalpindi. Methods: This descriptive study was conducted at Emergency Department of DHQ Teaching Hospital, Rawalpindi over 6 months. 500 patients presenting with chest pain were inducted consecutively. Diagnosis of ischemic and non-ischemic chest pain was based on clinical evaluation, electrocardiogram, and/or relevant investigations. Every patient was managed according to diagnosis. We collected and analyzed data regarding age, gender, diagnosis, and outcome of each subject. Results: Of the 500 patients, 51.6% were male and 48.4% female. Mean patient age was 39.86 ± 14.93 years. Non-ischemic and ischemic chest pain was diagnosed in 88.4% [n=442] and 10.4% [n=52] patients respectively. 1.2% [n=6] patients left before a specific diagnosis was made. Musculo-skeletal chest pain was commonest diagnosis in 32.2% of all and 36.4% patients with non-ischemic chest pain. Hypertension, diabetes mellitus, and past history of ischemic heart disease were significantly associated with ischemic chest pain, (p value < 0.05). Conclusion: Non-ischemic chest pain, specifically musculo-skeletal is commonest diagnosis made in chest pain patients attending medical emergency. Clues to diagnosis of ischemic chest pain in these patients are presence of hypertension, diabetes and past history of ischemic heart disease.

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