Clinical Events in Emergency Room Patient's with Chest Pain

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Abstract

Background
Prognosis must be evaluated in emergency room patients with acute chest pain in order to improve cost effective equation of admitting low risk patients and discharging home high risk patients .

Material and method
We studied the 30 days events 1280 patients with chest pain in the emergency room, according to final diagnosis.

Results
30% of the patients were admitted . Acute ischemic syndromes (acute myocardial infarction and unstable angina) were seen in 24% . Mortality was 2.18%, 90% from cardiac causes. Acute myocardial infarction mortality resulted 15% (19.3% Q, 5 .4% non Q), 2.8% in unstable angina, 4.25% in stable angina and 0 .24% in not cardiovascular chest pain 13.25% of Q acute myocardial infarction, 24 .3% non Q, 33 .3% unstable angina, 5% stable angina and 30.3% cardiovascular not coronary chest pain had recurrence of symptoms . Reacute myocardial infarction was seen in 4.8% of Q and 5A% non Q acute myocardial infarction . Only one patient with unstable angina developed acute myocardial infarction (0 .5%). Revascularization procedures were performed in 19.3% Q and 13.5% non Q acute myocardial infarction, 16 .6% unstable angina and 2.1% stable angina. No acute myocardial infarction appeared nor revascularization procedures were performed in not coronary chest pain or not cardiovascular chest pain patients .

Conclusions

Most of deaths were of cardiac origin . Acute myocardial infarctions rate was low but was responsible of 70% of deaths . Patients without acute ischemic syndroms were a good prognosis group .