Review of the Rapid Access Chest Pain Assessment Clinic at the Royal Hobart Hospital

Abstract

In 2014, a rapid access chest pain assessment clinic (RACPAC) was established at the Royal Hobart Hospital to address long waiting times and inefficient follow up through the general cardiology clinic. After one and a half years of action, we sought to review the referred patient characteristics and their subsequent need for coronary intervention. Baseline 5 year Absolute Cardiovascular Risk (ACR) was recorded to provide an overview of the prevalence of traditional risk factors in referred patients. After review and investigations, we recorded whether a primary cardiac diagnosis (including requiring coronary intervention) was reached. We reviewed patients referred between 01/07/2014 and 01/12/2015 (n=827). ACR was able to be calculated for 780 patients. Of these, 518 patients scored a low risk (66.4%), 90 patients moderate risk (11.5%) and 172 patients high risk (22.1%). Of the 797 patients who completed follow up, 86 patients (10.8%) had a primary cardiac diagnosis. Of the 827 patients who were seen by the clinic, 26 patients (3.1%) underwent coronary intervention. The frequency of patients having a primary cardiac diagnosis is similar to those reported in similar clinics elsewhere. The overall percentage of patients requiring revascularisation is low. 33.6% of patients recorded intermediate to high baseline ACR, and there may be opportunities to enhance risk factor management within the framework of the RACPAC.