Abstract
BackgroundChest pain is one of the most frequent causes of emergency department (ED) visits in high-income countries. Little is known about chest pain patients presenting to EDs of low- and middle-income countries (LMICs). The objective of this study was to describe the characteristics of chest pain patients presenting to emergency departments (EDs) of Pakistan and to determine the utilization of ED resources in the management of chest pain patients and their outcomes.MethodsThis study used pilot active surveillance data from seven major EDs in Pakistan. Data were collected on all patients presenting to the EDs of the participating sites to seek emergency care for chest pain.ResultsA total of 20,435 patients were admitted to the EDs with chest pain. The majority were males (M 60%, F 40%) and the mean age was 42 years (SD+/- 14). The great majority (97%, n = 19,164) of patients were admitted to the EDs of public hospitals compared to private hospitals and only 3% arrived by ambulance. Electrocardiograms (ECGs) were used in more than half of all chest pain patients (55%, n = 10,890) while cardiac enzymes were performed in less than 5% of cases. Chest X-rays were the most frequently performed radiological procedure (21%, n = 4,135); more than half of the admitted chest pain patients were discharged from the EDs and less than 1% died in the ED.ConclusionChest pain is a common presenting complaint in EDs in Pakistan. The majority received an ECG and the use of diagnostic testing, such as cardiac enzymes, is quite uncommon.
Highlights
Chest pain is one of the most frequent causes of emergency department (ED) visits in high-income countries
Almost 35% (n = 6,752) of all patients admitted with chest pain symptoms were in the 30-45 age group and less than 2% (n = 360) were in the 75-90 age group
97% (n = 19,164) of all chest pain patients were admitted to the ED of public hospitals and since the number of patients admitted to private hospitals was low (3%, n = 588), the analysis did not stratify results by hospital type
Summary
Chest pain is one of the most frequent causes of emergency department (ED) visits in high-income countries. Little is known about chest pain patients presenting to EDs of low- and middle-income countries (LMICs). Chest pain is a frequently occurring symptom affecting 20-40% of the general population worldwide [1,2,3]. It is responsible for more than 8 million visits to emergency departments (EDs) in the United States each year, making it the second most frequent cause of emergency visits [4] after stomach and abdominal pain [5]. Chest pain is the most common presenting complaint of an MI [17]
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