Chest pain in daily practice: occurrence, causes and management

Détails

Ressource 1Télécharger: 18561039.pdf (183.81 [Ko])
Etat: Serval
Version: Final published version
ID Serval
serval:BIB_B672539CBDE0
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Chest pain in daily practice: occurrence, causes and management
Périodique
Swiss Medical Weekly
Auteur(s)
Verdon F., Herzig L., Burnand B., Bischoff T., Pécoud A., Junod M., Mühlemann N., Favrat B.
ISSN
1424-7860
Statut éditorial
Publié
Date de publication
2008
Peer-reviewed
Oui
Volume
138
Numéro
23-24
Pages
340-347
Langue
anglais
Notes
[Texte intégral] http://www.smw.ch/docs/pdf200x/2008/23/smw-12123.PDF
Résumé
QUESTIONS UNDER STUDY: We assessed the occurrence and aetiology of chest pain in primary care practice. These features differ between primary and emergency care settings, where most previous studies have been performed. METHODS: 59 GPs in western Switzerland recorded all consecutive cases presenting with chest pain. Clinical characteristics, laboratory tests and other investigations as well as the diagnoses remaining after 12 months of follow-up were systematically registered. RESULTS: Among 24,620 patients examined during a total duration of 300 weeks of observation, 672 (2.7%) presented with chest pain (52% female, mean age 55 +/- 19(SD)). Most cases, 442 (1.8%), presented new symptoms and in 356 (1.4%) it was the reason for consulting. Over 40 ailments were diagnosed: musculoskeletal chest pain (including chest wall syndrome) (49%), cardiovascular (16%), psychogenic (11%), respiratory (10%), digestive (8%), miscellaneous (2%) and without diagnosis (3%). The three most prevalent diseases were: chest wall syndrome (43%), coronary artery disease (12%) and anxiety (7%). Unstable angina (6), myocardial infarction (4) and pulmonary embolism (2) were uncommon (1.8%). Potentially serious conditions including cardiac, respiratory and neoplasic diseases accounted for 20% of cases. A large number of laboratory tests (42%), referral to a specialist (16%) or hospitalisation (5%) were performed. Twentyfive patients died during follow-up, of which twelve were for a reason directly associated with thoracic pain [cancer (7) and cardiac causes (5)]. CONCLUSIONS: Thoracic pain was present in 2.7% of primary care consultations. Chest wall syndrome pain was the main aetiology. Cardio - vascular emergencies were uncommon. However chest pain deserves full consideration because of the occurrence of potentially serious conditions.
Mots-clé
Adult, Aged, Chest Pain, Female, Humans, Incidence, Male, Middle Aged, Primary Health Care, Prospective Studies
Pubmed
Web of science
Création de la notice
22/01/2009 14:41
Dernière modification de la notice
03/03/2018 20:46
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