Chest pain in general practice: Frequency, management, and results of encounter

Chest pain is a common reason for an encounter in general practice. The present investigation was set out to characterize the consultation rate of chest pain, accompanying symptoms, frequency of diagnostic and therapeutic interventions, and results of the encounter.

Cross-sectional data were collected from randomly selected patients in the German Sächsische Epidemiologische Studie in der Allgemeinmedizin 2 (SESAM 2) and analyzed from the Dutch Transition Project.

Overall, 270 patients from the SESAM 2 study consulted a general practitioner due to chest pain (3% of all consultations). Chest pain was more frequent in people aged over 45 years. The most common diagnostic interventions were physical examination, electrocardiogram at rest and analysis of blood parameters. For the majority of cases, the physicians arranged a follow-up consultation or prescribed drugs. The transition project documented 8117 patients reporting chest pain with a frequency of 44.5/1000 patient years (1.7% of all consultations). Physical examination was also the most common diagnostic intervention, and physician's advice the most relevant therapeutic one.

The most common causes for chest pain were musculoskeletal problems followed by cardiovascular diseases. Ischemic heart disease, psychogenic problems, and respiratory diseases each account for about 10% of the cases. However, acutely dangerous causes are rare in general practice.