Consultations with pain as presenting complaint at the emergency unit of a rural community hospital in Llay-Llay, between 2005 and 2007

Abstract

Chest pain is one of the most common presenting complaint at the emergency units. It includes banal and potentially lethal causes such as cardiovascular ones.

Materials and Methods: Cross-sectional descriptive study. Medical care records and AUGE protocols for chest pain in patients with chest pain as chief complaint attending the emergency unit at the Hospital San Francisco de LLay-Llay between January 2005 and December 2007 were used.

Results: Of a total of 957 patients, 48,69% were males and 51,3% were females, with a mean age of 50,16 years. The most prevalent diagnoses were costochondritis (37,5%); anxiety disorder (10,8%); non-specific precordialgia (8,5%), hypertensive crisis (6,6%) and unstable angina(3,6%). It is noteworthy that 2,4% were acute myocardial infarction cases, of which 73,9 percent occurred in males. The main risk factors were high blood pressure (39,7%), obesity (32,7%) and smoking (28,42 %). Substance consumption was evidenced in 33,99 percent, mainly involving alcohol and occurring in males. Hospital admission reached 11,8%, involving mainly males aged between 61and 80, with diagnoses of cardiovascular conditions.

Conclusion: In the great majority of the cases chest pain did not represent a severe condition, however it is critical to rule out serious diseases, particularly in patients with risk factors. Timely diagnosis and treatment should be based on a high degree of suspicion from the emergency unit physician, who has seldom tools to attain a specific and timely diagnosis that will enable the improvement of the prognosis of patients attending with chest pain as chief complaint.