Skip to main content

Evaluation of Chest Pain and Myocardial Ischemia

  • Chapter
  • First Online:
Comprehensive Cardiovascular Medicine in the Primary Care Setting

Part of the book series: Contemporary Cardiology ((CONCARD))

  • 1167 Accesses

Abstract

Chest pain is one of the most common presentations that clinicians are called upon to evaluate on an urgent basis in the office, clinic, or emergency department (ED). The CDC recorded 6.4 million visits to the ED for chest pain in 2006 1. Some of the challenges in the evaluation of chest pain include the broad spectrum of potential etiologies for chest pain, limited availability of definitive diagnostic modalities, and the potentially lethal consequences of serious conditions when not recognized early. Even when armed with all the tools of a full-service ED, often a definitive diagnosis cannot be arrived at. Instead, clinicians are forced to rely on the power of exclusion to discern if there is a threat to life and to decide how best to manage uncertain risks.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 139.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 179.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Pitts SR, Niska RW, Xu J, Burt CW. National Hospital Ambulatory Medical Care Survey: 2006 Emergency Department Summary. National Health Statistics Reports, No 7. Hyattsville, MD: National Center for Health Statistics; 2008.

    Google Scholar 

  2. Heron MP, Hoyert DL, Xu J, Scott C, Tejada-Vera B. Deaths: Preliminary Data for 2006. National Vital Statistics Reports, Vol 56, No 16. Hyattsville, MD: National Center for Health Statistics; 2008.

    Google Scholar 

  3. General and Family Practice Claim Summary. Rockville, MD: Physician Insurers Association of America; 2002.

    Google Scholar 

  4. Anderson JL, Adams CD, Antman EM, et al. ACC/AHA 2007 guidelines for the management of patients with unstable angina/non–ST-elevation myocardial infarction: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 2002 Guidelines for the Management of Patients with Unstable Angina/Non-ST-Elevation Myocardial Infarction). Circulation. 2007;116:803–877.

    Article  Google Scholar 

  5. Hochman JS, McCabe CH, Becker RC, Stone PH, et al. Outcome and profile of women and men presenting with acute coronary syndromes: a report from TIMI IIIB. TIMI Investigators. Thrombolysis in Myocardial Infarction. J Am Coll Cardiol. 1997;30:141–148.

    Article  PubMed  CAS  Google Scholar 

  6. Gibbons RJ, Balady GJ, Bricker JT, et al. ACC/AHA 2002 guideline update for exercise testing: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Exercise Testing). Circulation. 2002;106:1883–1892.

    Article  PubMed  Google Scholar 

  7. Shiga T, Wajima Z, Apfel CC. Diagnostic accuracy of transesophageal echocardiography, helical computed tomography, and magnetic resonance imaging for suspected thoracic aortic dissection: systematic review and meta-analysis. Arch Int Med. 2006;166:1350–1356.

    Article  Google Scholar 

  8. Stein PD, Fowler SE, Goodman LR, et al. Contrast enhanced multidetector spiral CT of the chest and lower extremities in suspected acute pulmonary embolism: results of the Prospective Investigation of Pulmonary Embolism Diagnosis II (PIOPED II). N Engl J Med. 2006;345:2317–2327.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2011 Springer Science+Business Media, LLC

About this chapter

Cite this chapter

Kosowsky, J.M., Huang, C. (2011). Evaluation of Chest Pain and Myocardial Ischemia. In: Toth, P., Cannon, C. (eds) Comprehensive Cardiovascular Medicine in the Primary Care Setting. Contemporary Cardiology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-60327-963-5_9

Download citation

  • DOI: https://doi.org/10.1007/978-1-60327-963-5_9

  • Published:

  • Publisher Name: Humana Press, Totowa, NJ

  • Print ISBN: 978-1-60327-962-8

  • Online ISBN: 978-1-60327-963-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics