Chest pain in primary care: epidemiology and pre-work-up probabilities

Eur J Gen Pract. 2009;15(3):141-6. doi: 10.3109/13814780903329528.


Background/objective: Chest pain is a common complaint and reason for consultation. We aimed to study the epidemiology of chest pain with respect to underlying aetiologies and to establish pre-work-up probabilities for the primary care setting.

Methods: We included 1212 consecutive patients with chest pain, aged 35 years and older, attending 74 general practitioners (GPs). GPs recorded symptoms and findings of each patient and provided follow-up information. An independent interdisciplinary reference panel reviewed clinical data of every patient and decided on the aetiology of chest pain at the time of patient recruitment.

Results: The prevalence of chest pain among all attending patients was 0.7%. The majority (55.9%) of patients were women. Mean age was 59 (35-93) years. Of these patients, 53.2% had chest pains at the time of consultation and 29.6% presented with acute (<48 hours' duration) chest pain. Pain originating from the chest wall was diagnosed in 46.6% of all patients, stable ischaemic heart disease (IHD) in 11.1%, and psychogenic disorders in 9.5%; 3.6% had acute coronary syndrome (ACS).

Conclusion: The study adds important information about the epidemiology of chest pain as a frequent reason for consulting primary care practitioners. We provide updated pre-work-up probabilities for IHD for each age and sex category.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Chest Pain / diagnosis
  • Chest Pain / epidemiology*
  • Chest Pain / etiology
  • Cross-Sectional Studies
  • Diagnosis, Differential*
  • Family Practice
  • Female
  • Germany / epidemiology
  • Humans
  • Male
  • Middle Aged
  • Primary Health Care*