Description of chest pain patients in the Emergency Department of a central hospital in Ajman

Abstract

Abstract Chest pain accounts for 8 million visits to the Emergency Department annually, which contributes to 5% to 10% of all ED visits. A recent study performed in the USA revealed that between 2% and 5% of acute coronary syndrome patients visiting the emergency department were missed without being diagnosed correctly. Study design: In this retrospective cross-sectional study, we analyzed the database in the SKGH emergency department for all patients presenting with chest pain between November 2017 and October 2019 using the SPSS program. Analysis included demographics: age, sex, country of origin, mode of arrival. Medical data: vital signs, triage grade, pain scale, seen within 72 hours or not, discharged within 7 days or not, final diagnosis and predisposition. The final diagnosis was differentiated into nonspecific chest pain, musculoskeletal chest pain, abdominal pain, anxiety, GERD, gastritis, stable angina, respiratory tract infections (upper and lower), aortic dissection, pneumothorax and pulmonary embolism. The exclusion criteria were as follows: patients less than 18 years old and 200 patients who met the inclusion criteria. Results: The mean age of the studied population was 49.22± 12.65 years, most of the studied population was male, the male to female ratio was 2:1, and the mode of transport was mainly walking (94, 47%), private vehicles (50, 25%) and by ambulance (31, 15.5%). The majority of patients were given triage 3 (moderate pain severity) 156 (78%), and the mean heart rate was 87.56 ± 17.97. In the 200 study population, 103 were diagnosed with nonspecific chest pain (103, 51.5%), and 27 (13.5%) were diagnosed with musculoskeletal chest pain. We found that 26 patients (13%) suffered from acute myocardial infarction (18 STEMI and 8 NSTEMI). Regarding the 18 patients with STEMI, 15 (83.3%) were males, 3 (16.7%) were females, 12 were sent for PCI, and 6 were sent for thrombolysis. There were 40 (65%) admitted patients with different diagnoses. Identifying patients with chest pain who have acute coronary syndrome (ACS) presents a challenge to ED physicians.