Establishment of chest pain center in emergency department of hospital can shorten the diagnosis-and-treatment time for patients with acute chest pain
  
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Key words:chest pain  diagnosis  
Author NameAffiliation
ZHANG Jian, et al  
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Abstract:
      Objective To investigate the value of the establishment of chest pain center(CPC)in Emergency Department(ED) of hospital in improving the diagnosis-and-treatment time for patients with acute chest pain. Methods CPC was established in the ED and there were three open days weekly which were randomly selected. The patients were diagnosed and treated by ED physicians according to routine clinical procedures at the rest time of the week. The causes of chest pain and diagnosis-and-treatment time duration of the patients were recorded. Results Totally 696 nontraumatic chest pain patients visited ED/CPC from January 2006 to December 2007,of which 244(35%)were cardiac chest pain cases, including 141 (20%)cases of acute myocardial infarction(AMI),81(12%)cases of unstable angina pectoris,17(2.4%)cases of stable angina pectoris,2(0.3%)cases of acute aortic dissection, and 3 (0.4%)cases of acute pulmonary embolism.452 cases were noncardiac chest pain patients, including 41(6%)cases of respiratory diseases,70(10%) cases of digestive diseases,41(6%) cases of chest wall diseases and,299 (42%) cases of psychological-psychotic diseases or other undetermined clinical conditions. Time for diagnosis and treatment for chest pain patients who visited CPC was significantly shortened,AMI(70.1±31.7)min vs (115±40.5)min(P<0.01);unstable angina pectoris (228±54)min vs (264±78)min(P=0.02);noncardiac chest pain (108±66)min vs (126±96)min(P=0.03).Conclusion Among acute chest pain patients, cardiac causes account for 35%, mainly including AMI and unstable angina pectoris, noncardiac causes account for 65%.Time for diagnosis and treatment for chest pain patients is significantly shortened by CPC pattern.
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