Outcome from a rapid-assessment chest pain clinic

QJM. 1998 May;91(5):339-43. doi: 10.1093/qjmed/91.5.339.


Chest pain accounts for much of the rising numbers of emergency admissions, but in-patient assessment is not necessarily the best way of dealing with these patients. We ran a 'rapid-assessment chest pain clinic' to provide an alternative route of assessment, and audited its outcome. General practitioners referred patients with recent-onset chest pain, increasing chest pain, chest pain at rest, or other chest pain of concern, on the understanding that they would be seen within 24 h. During 8 1/2 months, 334 patients were referred and 317 patients were seen, most of whom had exercise electrocardiography. A median of 6 months later, 278 patients were personally contacted to determine outcome. Of these, 18% had been admitted immediately with acute coronary syndromes, and 49% had been diagnosed as non-coronary chest pain (none of whom subsequently infarcted or died). Continuing symptoms were infrequent, and satisfaction was high, although 13% of patients had been revascularized. A significant number of patients required immediate admission and/or ultimate revascularization, but many more did not. The majority of these patients had non-coronary chest pain, and this diagnosis was substantiated by their excellent outcome and (in some cases) by further investigation.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Chest Pain / etiology*
  • Chest Pain / therapy
  • Coronary Disease / diagnosis
  • Coronary Disease / therapy
  • Female
  • Follow-Up Studies
  • Hospitals, Public
  • Humans
  • Male
  • Medical Audit
  • Middle Aged
  • Outcome Assessment, Health Care*
  • Pain Clinics / statistics & numerical data*
  • Patient Satisfaction
  • Scotland