[Fast track chest pain pathway in emergency department].
Acute chest pain is a common reason of consultation in the emergency department. The difficulty lies in discriminating patients with acute coronary syndrome or other life-threatening conditions from those non-cardiovascular, non-life-threatening chest pain. Only 15 to 25 % of patients with acute chest pain actually have acute coronary syndrome. Algorithms using high sensitivity troponin at admission and a second assessment 1 or 3hours later are validated to "rule in" or "rule out" the diagnosis of non ST-elevation myocardial infarction. This may reduce the delay for the diagnosis translating into shorter stay in the emergency department. Those algorithms must be interpreted in the context of clinical and ECG criteria.
Service de cardiologie, centre hospitalier Le Raincy-Montfermeil, rue du Général-Leclerc, 93370 Montfermeil, France. Electronic address: olivierparisnallet@gmail.com.
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Nallet
Service de cardiologie, centre hospitalier de Vichy, 03200 Vichy, France.
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Ketata
Service de cardiologie, centre hospitalier de Vichy, 03200 Vichy, France.
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Ferrier
Service de cardiologie, centre hospitalier de Vichy, 03200 Vichy, France.
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Marcaggi
D054058:Acute Coronary Syndrome / Q000175:diagnosis* / Q000453:epidemiology; D000789:Angina, Unstable / Q000175:diagnosis / Q000453:epidemiology; D002637:Chest Pain / Q000453:epidemiology / Q000209:etiology*; D019091:Critical Pathways / Q000458:organization & administration*; D003430:Cross-Sectional Studies; D003937:Diagnosis, Differential; D004562:Electrocardiography; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D006801:Humans; D009203:Myocardial Infarction / Q000175:diagnosis / Q000453:epidemiology; D018579:Patient Selection; D010493:Pericarditis / Q000175:diagnosis / Q000209:etiology; D057216:Propensity Score; D014336:Troponin / Q000097:blood
D014336:Troponin
Chest pain: Acute coronary syndrome; Douleur thoracique; Emergency department; High sensitivity troponin; Services d’urgence; Syndrome coronarien aigu; Troponine de haute sensibilité