Diagnóstico y manejo precoz del paciente con dolor torácico

Chest pain is one of the most common reasons for seeking medical advise. Although many patients initially appear to have an acute coronary syndrome, a significant number of admissions for suspected ischemic heart disease could be avoided if the initial diagnosis was more accurate. On the other hand, some 5-10% of patients who present with this symptom are discharged from the emergency department only to experience an acute myocardial infarction either immediately or within the following few days, with a consequent high death rate. Moreover, the efficacy of thrombolysis and primary angioplasty in patients with acute myocardial infarction depends on how soon these techniques can be implemented. In addition, recent treatment recommendations for non-ST-elevation acute coronary syndromes indicate that patients who could benefit from more intensive treatment should be selected as soon as possible. The early diagnosis and management of patients with chest pain in special units reduces the number of patients admitted with non-coronary chest pain, the number an with acute coronary syndrome who are discharged from emergency departments inappropriately, and the delay between admission and ECG and starting treatment in high-risk patients. Being inexpensive and cost-effective, Chest Pain Units should be universally available.