Study of Frequency of Acute Coronary Syndromes In Patients Presenting with Chest Pain in a Primary Health Care Center (PHCC)

Abstract

Background: Ischemic myocardial disease is the most common cardiovascular disease, associated with high morbidity and mortality. Objective: Study and distinguish acute heart episodes from cases of chest pain, in patients attending a PHCC located in Goura of Korinthos, Greece. Methods: Among all cases of chest pain examined during January-August 2019, 90 patients with acute coronary syndrome (ACS) were studied. Most participants were men (71%) aged 61-70 (31%). Results: A previous heart episode was mentioned by 28,6%. Among them, 22% did not comply with their medication regimen and 14.3% had been examined with coronary angiography. Percutaneous Coronary Intervention has been performed to 11.4% and 1.4% had undergone coronary-artery bypass. Risk factors were; hypertension(52.9%),smoking(37.2%), dyslipidemia (27.1%). Clinical manifestations were;chest pain 62.9%,perspiration 21.4%,numbness of extremities 18.6%, reflection of chest pain in the back 18.6% and nausea/respiratory distress 2.9%. Electrocardiographic findings consistent with STEMI were found in 32% of patients. Α new Left Bundle Branch Block was apparent in 5.7% of patients. Episodes of unstable angina with ischemic repolarization disorders were recorded in 29.4%. All patients after evaluation and initial treatment were transported to hospital. Finally, one patient (1,42%) died. Conclusion: There is a great incidence of acute coronary events in a Greek PHCC. General practitioners, following international guidelines deal with them successfully, despite lacking resources. Initial evaluation and treatment of ACS in a PHCC is of vital importance and contributes to lower morbidity and mortality rates.