title: [Chest pain unit: first experience in Chile].
abstract: BACKGROUND
  In large series, nearly 60% of admissions for suspected acute coronary syndrome (ACS) had a non-coronary etiology of the pain. However, short term mortality of non recognized ACS patients, mistakenly discharged from the emergency room is at least twice greater than the expected if they would had been admitted. The concept of a chest pain unit (CPU) is a methodological approach developed to address these issues.
  
  
  OBJECTIVE
  To evaluate the efficacy of a CPU in the emergency room of a general hospital for evaluation of acute chest pain.
  
  
  METHODS
  Prospective study of patients with chest pain admitted in the CPU. After a clinical, electrocardiographic and laboratory evaluation with cardiac injury serum markers, patients were stratified in three risk groups, based on the likelihood of ACS of the American Heart Association. High probability patients were admitted to the Coronary Unit (CU) for treatment. Moderate probability patients remained in the CPU for further evaluation and low probability patients were discharged with telephonic follow-up.
  
  
  RESULTS
  Of 407 patients, 35, 30 and 35% were stratified as high, intermediate and low probability ACS, respectively. Among patients admitted with high probability, 73% had a confirmed ACS diagnosis. Among intermediate probability patients, 86% were discharged after an evaluation in the CPU without adverse events in the follow-up.
  
  
  CONCLUSIONS
  Structured risk evaluation approach in a CPU improves the management of acute chest pain, identifying high probability patients for fast admission and start of treatment in a CU and allowing safe discharge of low probability ones.
authors.affiliation: Departamento de Enfermedades Cardiovasculares, Hospital Clínico y Facultad de Medicina, Pontifica Universidad Católica de Chile, Chile. pcastro@med.puc.cl.
authors.forename: Pablo
authors.initials: P
authors.lastname: Castro
authors.forename: Ramón
authors.initials: R
authors.lastname: Corbalán
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Isa
authors.forename: Luigi
authors.initials: L
authors.lastname: Gabrielli
authors.forename: Osvaldo
authors.initials: O
authors.lastname: Pérez
authors.forename: Gastón
authors.initials: G
authors.lastname: Chamorro
authors.forename: Bernardita
authors.initials: B
authors.lastname: Garayar
authors.forename: Ricardo
authors.initials: R
authors.lastname: Baeza
authors.forename: Ismael
authors.initials: I
authors.lastname: Vergara
authors.forename: Iván
authors.initials: I
authors.lastname: Godoy
authors.forename: Mónica
authors.initials: M
authors.lastname: Acevedo
authors.forename: Alejandro
authors.initials: A
authors.lastname: Fajuri
authors.forename: Marcelo
authors.initials: M
authors.lastname: Fernández
authors.forename: José Miguel
authors.initials: JM
authors.lastname: Mardones
authors.forename: Alex
authors.initials: A
authors.lastname: Bittner
authors.forename: José Antonio
authors.initials: JA
authors.lastname: Rodríguez
mesh_terms: D054058:Acute Coronary Syndrome / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology; D001938:Brazil / Q000453:epidemiology; D002637:Chest Pain / Q000209:etiology* / Q000401:mortality / Q000473:pathology; D003325:Coronary Care Units; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D011336:Probability; D011446:Prospective Studies; D012307:Risk Factors