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Clinical profile and outcome of patients presenting with non-traumatic chest pain to emergency in the department of internal medicine of a tertiary care hospital in Northern India

Author: 
Dr. Ashish Sharma, Dr. Nishant Nadda, Dr. Rajesh Kashyap, Dr. Anupam Parashar, Dr. Rajesh Sharma and 4Dr. Rajeev Merwaha
Subject Area: 
Health Sciences
Abstract: 

Background: Patients presenting with chest pain are a common daily occurrence in emergency medicine. Chest pain is quite common and up to 25% of the general population experience it in some form during their lifetime. The causes for cardiac-mimicking chest pain are numerous, but the most common causes can be narrowed down by system: musculoskeletal, gastrointestinal, psychological, and pulmonary. Proper management of non-cardiac chest pain will lead to better utilization of resources, reduced health care costs, and an increased quality of life for patients. Objectives: To study the clinical profile and outcome of patients presenting with non-traumatic chest pain to emergency in the Department of Internal Medicine of tertiary care centre of Northern India. Methods: The Observational Cross-Sectional study was conducted in the emergency department of Medicine, of tertiary care center of Northern India, from 1st July 2016 to 30th June 2017, among the patients presenting with non- traumatic chest pain and who satisfied the inclusion criteria. Results: Out of 271 patients who reported to emergency with complaints of chest pain, 98 (36.2%) patients had CVS cause of chest pain, 65 (24%) had GIT cause, 63 (23.2%) had MSK cause, 25 (9.2%) had respiratory cause, 14 (5.2%) had psychiatric cause and 4 (2.2%) patients had other causes of chest pain. Conclusion: As the chest pain is the most common symptom in general practice and the present study also suggests that cardiac causes should be considered as prime cause until they are ruled out. Therefore, thorough history and physical examination should be part of initial evaluation of all patients with chest pain. However further large clinical as well as epidemiological studies with robust study design need to be conducted to confirm and further elaborate on our observations.

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