Evaluation of the Patient with Acute Chest Pain

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Abstract
The evaluation of acute chest pain remains challenging, despite many insights and innovations over the past two decades. The percentage of patients who present at the emergency department with acute chest pain and are admitted to the hospital may actually be increasing.16 The reasons for clinical caution are familiar to most physicians. Patients with acute myocardial infarction who are mistakenly discharged from the emergency department have short-term mortality rates of about 25 percent, at least twice what would be expected if they were admitted.7 The legal costs that can result from such cases constitute the largest category of losses . . .

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