[ANMCO/SIMEU Consensus document: In-hospital management of patients presenting with chest pain].
Chest pain is a common general practice presentation that requires careful diagnostic assessment because of its diverse and potentially serious causes. However, the evaluation of acute chest pain remains challenging, despite many new insights over the past two decades. The percentage of patients presenting to the emergency departments because of acute chest pain appears to be increasing. Nowadays, there are two essential chest pain-related issues: 1) the missed diagnoses of acute coronary syndromes with a poor short-term prognosis; 2) the increasing percentage of hospitalizations of low-risk cases.It is well known that hospitalization of a low-risk chest pain patient can lead to unnecessary tests and procedures, with an increasing trend of complications and burden of costs. Therefore, the significantly reduced financial resources of healthcare systems induce physicians and administrators to improve the efficiency of care protocols for patients with acute chest pain. Despite the efforts of the Scientific Societies in producing statements on this topic, in Italy there is still a significant difference between emergency physicians and cardiologists in managing patients with chest pain. For this reason, the aim of the present consensus document is double: first, to review the evidence-based efficacy and utility of various diagnostic tools, and, second, to delineate the critical pathways (describing key steps) that need to be implemented in order to standardize the management of chest pain patients, making a correct diagnosis and treatment as uniform as possible across the entire country.
U.O. Cardiologia, Ospedale dell'Angelo, Mestre (VE).
Guerrino
G
Zuin
U.O.C. Cardiologia Indirizzo Riabilitativo, Ospedale Madonna del Soccorso, San Benedetto del Tronto (AP).
Vito Maurizio
VM
Parato
Medicina d'Urgenza, Ospedale Madonna del Soccorso, San Benedetto del Tronto (AP).
Paolo
P
Groff
U.O.C. Cardiologia, Ospedale Garibaldi-Nesima, Azienda di Rilievo Nazionale e Alta Specializzazione "Garibaldi", Catania.
Michele Massimo
MM
Gulizia
S.C. Centro Cardiovascolare, Azienda Sanitaria Universitaria Integrata, Trieste.
Andrea
A
Di Lenarda
S.O.C. Cardiologia, A.O. Santa Maria degli Angeli, Pordenone - S.C. Medicina d'Urgenza, Azienda Ospedaliera di Pinerolo (TO).
Matteo
M
Cassin
Gian Alfonso
GA
Cibinel
S.C. Cardiologia, Azienda Ospedaliera di Perugia, Perugia.
Maurizio
M
Del Pinto
U.O. Cardiologia, Ospedale ASST, Cremona.
Giuseppe
G
Di Tano
S.O.C. Cardiologia, Ospedale Castelli, Verbania.
Federico
F
Nardi
Dipartimento Cardiovascolare, ASST Papa Giovanni XXIII, Bergamo.
Roberta
R
Rossini
Dipartimento d'Emergenza-Accettazione, A.O. San Giovanni-Addolorata, Roma.
Maria Pia
MP
Ruggieri
U.O.C. Medicina d'Urgenza e Pronto Soccorso, Ospedale San Paolo, Napoli.
Enrico
E
Ruggiero
U.O. Cardiologia-UTIC, Ospedale di Loreto Mare, Loreto Mare (NA).
Fortunato
F
Scotto Di Uccio
Cardiologia Intensiva Integrata, AOU Careggi, Firenze.
Serafina
S
Valente
D006801:Humans; D054058:Acute Coronary Syndrome / Q000175:diagnosis / Q000628:therapy; D002637:Chest Pain / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D003937:Diagnosis, Differential; D004636:Emergency Service, Hospital; D019317:Evidence-Based Medicine; D007558:Italy; D009203:Myocardial Infarction / Q000175:diagnosis / Q000628:therapy; D011379:Prognosis; D018570:Risk Assessment; D012307:Risk Factors