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Some chest pain patients may benefit from more evaluation

WINSTON-SALEM, N.C. New research shows that almost 3 percent of patients who went to hospital emergency rooms with chest pain but who weren't initially diagnosed with heart problems went on to have heart attacks or other heart-related events within a month.

The study, by Wake Forest University Baptist Medical Center researchers and colleagues from seven other medical centers, will be reported in the December issue of Annals of Emergency Medicine and is currently available on-line.

"Not all chest pain is heart related and, unfortunately, some patients whose pain is diagnosed as non-heart related end up having heart attacks," said Chadwick Miller, M.D., lead researcher, from Wake Forest Baptist. "We wanted to know how frequently this happens and what characteristics these patients have in common that could help physicians in the difficult task of evaluating chest pain."

The researchers reviewed data from 15,608 patients who were evaluated for chest pain in nine hospital emergency departments between June 1999 and July 2001. All patients with a diagnosis of non-cardiac chest pain were contacted by phone, and researchers reviewed their hospital records to determine their outcome at 30 days. Other diagnoses included heart attack, low-risk chest pain, unstable angina and high-risk chest pain.

The analysis found that 2.8 percent of patients who were initially diagnosed with non-cardiac chest pain had definitive evidence of a heart attack, unstable angina, cardiac death or a procedure to re-open blocked heart vessels within a month after their diagnosis. Another 3.5 percent of the patients had possible evidence of an adverse heart event, but there was not enough information to say for sure.

Miller said these levels may seem relatively low, but would represent a significant level of death and illness on a nationwide scale.

There is no single, definitive test to diagnose heart attacks, making it difficult to evaluate chest p
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Contact: Karen Richardson
krchrdsn@wfubmc.edu
336-716-4453
Wake Forest University Baptist Medical Center
29-Oct-2004


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