[Acute chest pain]

Area of Science:

• Cardiology
• Vascular Surgery
• Emergency Medicine

Background:

• Acute chest pain is a common medical presentation with diverse etiologies, including cardiac, vascular, and functional disorders.
• Acute coronary syndromes (ACS) and ascending aortic dissections are critical conditions requiring timely diagnosis and management.
• Noncardiac chest pain and functional abnormalities can significantly impact quality of life.

Purpose of the Study:

• To outline diagnostic and management strategies for acute chest pain.
• To differentiate between life-threatening cardiac and vascular emergencies and noncardiac causes of chest pain.
• To emphasize the importance of accurate diagnosis for prognosis and patient management.

Main Methods:

• Review of current medical literature and clinical guidelines for acute chest pain management.
• Categorization of chest pain etiologies, focusing on acute coronary syndromes (ACS), aortic dissection, and pericarditis.
• Discussion of therapeutic interventions, including pharmacological treatments and invasive procedures.

Main Results:

• ACS management varies based on risk stratification, from conservative treatment to urgent reperfusion therapy (e.g., percutaneous coronary intervention for STEMI).
• Acute ascending aortic dissection necessitates immediate surgical intervention for type A and conservative management with hypertension control for type B.
• Acute pericarditis, while often benign, requires prompt treatment, especially if cardiac tamponade is present, with pericardiocentesis as a key intervention.

Conclusions:

• Accurate differentiation of chest pain causes is essential for appropriate treatment and improved patient outcomes.
• Functional chest pain requires exclusion of organic heart disease and patient education to manage quality of life impacts.