Chest Pain: Who Needs Additional Testing Beyond ECG and Troponin?
Rakhee Makhija1, Debabrata Mukherjee1
1Texas Tech University Health Sciences Center, El Paso, Texas, USA.
JACC. Case Reports
|November 12, 2021
Summary
This case series highlights two distinct presentations of chest pain in adults. It emphasizes the importance of considering various etiologies for chest discomfort in emergency department evaluations.
Area of Science:
- Cardiology
- Emergency Medicine
Background:
- Chest pain is a common presenting complaint in emergency departments.
- Accurate diagnosis is crucial for appropriate management and patient outcomes.
Observation:
- Case 1: A 45-year-old man presented with acute chest discomfort following a physical altercation.
- Case 2: A 54-year-old woman with a history of diabetes mellitus, hypertension, and dyslipidemia reported 10 days of exertional chest pain.
Findings:
- The cases illustrate diverse triggers and characteristics of chest pain presentations.
- Differential diagnosis for chest pain requires thorough patient history and clinical assessment.
Implications:
- These cases underscore the need for comprehensive evaluation of chest pain in the emergency setting.
- Understanding varied patient presentations aids in timely and accurate diagnosis of cardiac and non-cardiac causes of chest pain.
Keywords:
ACS, acute coronary syndrome(s)CAD, coronary artery diseaseCCTA, coronary computed tomography angiographyCDP, clinical decision pathwayECG, electrocardiogramED, emergency departmentEDACS, Emergency Department Assessment of Chest Pain ScoreFFR-CT, fractional flow reserve–computed tomographyHEART, History, ECG, Age, Risk factors and TroponinMACE, major adverse cardiac eventsacute coronary syndromechest paincomputed tomographyhs-cTn, high sensitivity-troponinmADAPT, Modified Accelerated Diagnostic protocol to Assess chest Pain using Troponinsnuclear medicine
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