Related Experiment Videos
Prognosis of patients with "chest pain ?cause"
Insights
Patients with chest pain of uncertain cause experienced few adverse events and maintained high employment rates one year post-admission. This diagnostic category offers a clinically useful, simple approach for patient assessment.
Area of Science:
- Cardiology
- Clinical Medicine
Background:
- Coronary care units manage patients with acute chest pain.
- Accurate diagnosis is crucial for patient outcomes and resource allocation.
Purpose of the Study:
- To evaluate the one-year prognosis of patients admitted to coronary care units with chest pain of uncertain cause.
- To compare outcomes of chest pain of uncertain cause with myocardial infarction and ischaemic heart disease.
Main Methods:
- Prospective follow-up of 662 patients admitted to coronary care units over 12 months.
- Categorization into diagnostic groups: myocardial infarction, ischaemic heart disease, chest pain ?cause, and others.
- One-year assessment of mortality, readmission, and employment status.
Main Results:
- Eighty-nine patients (13%) were classified as chest pain ?cause.
- No deaths occurred in the chest pain ?cause group during follow-up; two were readmitted with myocardial infarction.
- 75% of chest pain ?cause patients remained employed one year later, compared to 36% with ischaemic heart disease.
- Chest pain ?cause patients experienced fewer long-term problems than those with diagnosed ischaemic heart disease.
Conclusions:
- Chest pain of uncertain cause is a clinically useful diagnostic category.
- Patients in this category have a favorable one-year prognosis with good functional recovery.
- Simple investigations are sufficient for allocating patients to this diagnostic group.
Abstract:
All 662 patients admitted to the two coronary care units in Nottingham during 12 consecutive months were followed up prospectively for one year. At the time of discharge from hospital they were categorised according to set criteria into the following diagnostic groups: definite, probable, or possible myocardial infarction; ischaemia heart disease without infarction; chest pain ?cause; and other diagnoses. Eighty-nine patients (13% of admissions) were categorised as having chest pain ?cause. No deaths occurred among these patients during the observation period, although two were readmitted with myocardial infarction. Patients with chest pain ?cause had few problems during the year after admission, and at the end of that time 75% were in their original employment. Patients admitted with ischaemic heart disease had a similar death rate (between six weeks and one year after admission) to those with myocardial infarction, and only 36% were in their original employment one year after admission. Chest pain ?cause is a clinically useful diagnostic category to which patients may be allocated after only simple investigations.