الفهرس | Only 14 pages are availabe for public view |
Abstract .Evaluation of chest pain should follow a comprehensive, systematic, protocol-driven approach. The goals of initial assessment of the patient with chest pain are; a) to distinguish patients with an ACS or other serious etiology; b) to assess the level of risk of adverse outcomes in patients with a suspected ACS or other serious etiology; and c) to initiate rapid treatment in patients with serious conditions, according to current guidelines. 2. Chest pain centers facilitate rapid, efficient management of high risk patients with an ACS and identification of lower risk patients who do not require hospital admission, by application of accelerated diagnostic protocols. 3. Chest pain centers may have a dedicated environment and the coordinated efforts of specialized personnel to attain the objectives of safe, accurate and cost-effective management of patients presenting with chest pain. 4. Low-risk patients presenting to the emergency department with chest pain can be identified by clinical criteria (history, physical examination, and electrocardiogram). 5. Meticulous evaluation for the recognition of typical and atypical presentations of ischemic chest discomfort is mandatory for physicians managing patients with this presentation. 6. Accelerated diagnostic protocols should include at least 6 to 12 h of observation, ECG monitoring, and serial cardiac biomarkers |