Approach to the Patient Presenting with Chest Pain

Caring for the emergency department patient with chest pain represents an important challenge to the emergency physician. Chest pain is the second most common presentation among all emergency department patients, accounting for approximately 6 million visits per year in the United States. Chest pain may represent a benign condition or a time-critical life threat; symptom overlap between benign and serious conditions can make an accurate chest pain diagnosis challenging. This review covers the pathophysiology, assessment, stabilization, diagnosis and treatment, and disposition and outcomes of chest pain.  This review contains 1 figure, 25 tables, and 36 references. Key words: acute coronary syndrome, acute myocardial infarction,  angina pectoris, chest pain, coronary artery disease,  pulmonary embolism, high sensitivity troponin, HEART Score, EDAC score, cardiac CT Angiogram