Summary
The characteristics and management of patients with non-traumatic chest pain in hospital emergency departments. The results of the EVICURE II study
García-Castrillo Riesgo L, Recuerda Martínez E, Loma-Osorio A, García-Camarero T, García-Cases C, Epelde Gonzalod F, Nuñez Castillo P, Sierra Piqueres C
Affiliation of the authors
Emergency Department. Hospital Universitario Marqués de Valdecilla, Santader, Spain. Centro de Salud Virgen de África, DS Sevilla, Spain. UCI. Hospital Echagorrichu, Spain. Departamento Médico Lacer, Spain. Emergency Department. Hospital de
DOI
Quote
García-Castrillo Riesgo L, Recuerda Martínez E, Loma-Osorio A, García-Camarero T, García-Cases C, Epelde Gonzalod F, et al. The characteristics and management of patients with non-traumatic chest pain in hospital emergency departments. The results of the EVICURE II study. Emergencias. 2008;20:391-8
Summary
Objective: Identifying patients with acute coronary syndrome (ACS) attending
emergency services with nontraumatic chest pain is a complex process in spite of current
guidelines. This study aimed to describe the assessment process in order to identify
aspects in need of improvement.
Design: A prospective, observational multicenter study enrolling consecutive patients
with nontraumatic chest pain suggestive of ischemic heart disease.
Results: In a total of 1440 patients studied, the prevalence of ACS was 23.5%, with a
ratio of ST-elevation myocardial infarction (STEMI) to non-STEMI cases of 1:3 according
to emergency service diagnoses. The first electrocardiogram (ECG) was classified as
inconclusive in over 70% of the cases. More than 1 ECG was required in 40%. The
median delay in reaching emergency services was 169 minutes and the first ECG was
then performed in less than 10 minutes in slightly more than 40% of the patients. The
overall agreement on a diagnosis of ACS for admitted patients was 0.64 (ê index).
Conclusion: The results reveal the complexity of this diagnostic process and identify
areas for possible improvement.