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 1% of office-based visits.[2]McConaghy JR, Oza RS. Outpatient diagnosis of acute chest pain in adults. Am Fam Physician. 2013 Feb 1;87(3):177-82. https://www.aafp.org/afp/2013/0201/p177.html http://www.ncbi.nlm.nih.gov/pubmed/23418761?tool=bestpractice.com

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.