The diagnosis of chest pain is not always due to a cardiac cause such as myocardial infarction. In fact, non-cardiac causes may present with similar signs and symptoms. This article delves into the differential using an anatomical approach describes how thorough history, physical examination well specific tests are required confirm each diagnosis.

INTRODUCTION Chest pain in children is common, but rarely heralds serious underlying cardiac pathology. Despite this, the anxiety of missing a potentially life threatening condition creates a large burden of referrals and diagnostic testing. We evaluated patients diagnosed with 1 of 9 serious cardiac diseases and detailed the clinical signs and symptoms of the patients presenting with chest pai...

In cardiac syndrome X, the presence of ischaemic-like ST segment changes during chest pain, in the absence of epicardial coronary stenoses, suggests that myocardial ischaemia caused by coronary microvascular dysfunction is responsible for angina. This view is supported by the documentation of abnormalities in myocardial perfusion on radionuclide studies 3 and abnormal coronary blood flow respon...

spontaneous coronary artery dissection (scad) is a rare and important cause of acute coronary syndrome and sudden cardiac death. various etiologies are thought to be responsible for this condition, among which underlying atherosclerosis seems to be the most common. scad is predominant in women and is usually diagnosed via coronary artery angiography. therapeutic interventions include medical th...

We present a case of cardiac ischaemia associated with capecitabine chemotherapy. An elderly female receiving capecitabine chemotherapy developed acute onset severe anterior chest pain associated with ischaemic changes on ECG. The pain and ECG changes failed to respond to thrombolysis and she proceeded to coronary angiogram and stenting of a thrombosed right coronary vessel. She inadvertently r...

INTRODUCTION Increasing demand for public healthcare and access to specialist care has become a major concern. Characterising the referral pattern to a national centre's cardiology specialist outpatient clinics (SOCs) and the diagnostic outcomes may be useful in formulating referral guidelines to contain rising demand. MATERIALS AND METHODS A prospective observational followup study was condu...

OBJECTIVE To assess the incidence of prognostically important myocardial damage in patients with chest pain discharged from the emergency department. DESIGN Prospective observational study. SETTING District general hospital emergency department. PARTICIPANTS 110 patients presenting with chest pain of unknown cause who were subsequently discharged home after cardiac causes of chest pain we...

OBJECTIVES Chest pain is a common reason for referral to pediatric cardiologists and often leads to an extensive cardiac evaluation. The objective of this study is to describe current management practices in the assessment of pediatric chest pain and to determine whether a standardized care approach could reduce unnecessary testing. PATIENTS AND METHODS We reviewed all patients, aged 7 to 21 ...

OBJECTIVE To determine the feasibility, safety and effectiveness of a structured clinical pathway for stratification and management of patients presenting with chest pain and classified as having intermediate risk of adverse cardiac outcomes in the subsequent six months. DESIGN Prospective clinical audit. PARTICIPANTS AND SETTING 630 consecutive patients who presented to the emergency depar...