Evaluation of chest pain in primary care: Differential diagnosis of emergencies
Chest pain is a common and serious symptom encountered in various medical practices. The complaint of chest pain should always be taken seriously, and the diagnostic process should be expedited swiftly. Since chest pain can be a symptom of various diseases, a rapid differential diagnosis is essential. The most common causes of chest pain are known to be chest wall pain, reflux esophagitis, and costochondritis. However, other potential etiologies, such as pulmonary, psychological, and cardiovascular causes, should also be considered. In approximately 15% of patients with chest pain, a definitive diagnosis may not be established. Therefore, it is crucial to always consider cardiac causes for chest pain and exclude cardiac etiology.
The evaluation of chest pain should include a detailed medical history, physical examination, and appropriate diagnostic tests. Additionally, information regarding the patient’s risk factors and medical history should be collected. Electrocardiogram (EKG) is important in assessing acute coronary syndrome, and it can help decide whether the patient needs to be referred to the emergency department. In the diagnosis of chest pain, predictive tools such as the Marburg Heart Score and the INTERCHEST clinical decision rule can be used alongside clinical evaluation. The rapid and accurate application of the physician’s experience and familiar algorithms is of critical importance in the diagnostic process.
Chest pain may present with different characteristics in different age groups. Therefore, individual characteristics such as age and gender should also be considered during the evaluation. The management of patients presenting with chest pain is of great importance in ensuring the accurate diagnosis and planning appropriate treatment processes. In conclusion, the complaint of chest pain is a serious symptom that requires prompt and effective approaches to provide accurate diagnosis and treatment. Primary healthcare professionals should possess sufficient knowledge and skills in the differential diagnosis and management of chest pain. This plays a critical role in ensuring patient safety and well-being.
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