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Chest pain in young patients in an office setting: cardiac diagnoses, outcomes, and test burden
Herbert E Cohn1, Lucy W Arnold
1Harvard Vanguard Medical Associates, Children's Hospital, Boston, MA 02215, USA.
Abstract:
This study determined the incidence of cardiac diagnoses demonstrably related to chest pain in young patients and determined whether those with exertional chest pain were more likely to have a cardiac diagnosis. It evaluated the course of patients with chest pain after pediatric cardiology evaluation regarding interventions, outcomes, and additional test burden. This was a retrospective study of 203 patients with an office pediatric cardiology assessment of chest pain from January 2000 through December 2004. Fifteen patients (7.4%) had cardiac diagnoses, 5 (2.5%) had cardiac diagnoses demonstrably related to their chest pain complaints (arrhythmias, mitral valve prolapse), and none had ischemia. Exertional chest pain, in this study, did not increase the risk of having a cardiac diagnosis. Following evaluation, 80% of patients did not return for complaints of chest pain. Ten percent had 2 or more additional visits to any medical site for chest pain but no additional cardiac diagnoses were found.
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