Evaluation of chest pain

Chest pain is a common chief complaint, accounting for approximately 5% of all emergency department visits in the US per year.[1]Rui P, Kang K. Centers for Disease Control and Prevention, National Center for Health Statistics. National hospital ambulatory medical care survey: 2017 emergency department summary tables. 2017 [internet publication]. https://www.cdc.gov/nchs/ahcd/index.htm It is the presenting complaint in up to 1% of office-based visits.[2]Centers for Disease Control and Prevention. National Center for Health Statistics: survey results and products - 2016 National Ambulatory Medical Care Survey summary tables. Aug 2023 [internet publication]. https://www.cdc.gov/nchs/ahcd/web_tables.htm#2016 ​​

Chest pain may be caused by either benign or life-threatening etiologies and is usually divided into cardiac and noncardiac causes.

Acute coronary syndrome (ACS), encompassing unstable angina, ST-elevation myocardial infarction, and non-ST-elevation myocardial infarction, may not be the most common etiology in patients presenting with chest pain, but excluding ACS is vital because of the mortality associated with untreated myocardial infarction.

This topic concentrates on the evaluation of acute chest pain in the emergency setting.