RT Book, Section
A1 Morrow, David A.
A2 Jameson, J. Larry
A2 Fauci, Anthony S.
A2 Kasper, Dennis L.
A2 Hauser, Stephen L.
A2 Longo, Dan L.
A2 Loscalzo, Joseph
SR Print(0)
ID 1160046970
T1 Chest Discomfort
T2 Harrison's Principles of Internal Medicine, 20e
YR 2018
FD 2018
PB McGraw-Hill Education
PP New York, NY
SN 9781259644016
LK accessmedicine.mhmedical.com/content.aspx?aid=1160046970
RD 2024/04/18
AB Chest  discomfort  is  among  the  most  common  reasons  for  which  patients  present  for  medical  attention  at  either  an  emergency  department  (ED)  or  an  outpatient  clinic.  The  evaluation  of  nontraumatic  chest  discomfort  is  inherently  challenging  owing  to  the  broad  variety  of  possible  causes,  a  minority  of  which  are  life-threatening  conditions  that  should  not  be  missed.  It  is  helpful  to  frame  the  initial  diagnostic  assessment  and  triage  of  patients  with  acute  chest  discomfort  around  three  categories:  (1)  myocardial  ischemia;  (2)  other  cardiopulmonary  causes  (pericardial  disease,  aortic  emergencies,  and  pulmonary  conditions);  and  (3)  non-cardiopulmonary  causes.  Although  rapid  identification  of  high-risk  conditions  is  a  priority  of  the  initial  assessment,  strategies  that  incorporate  routine  liberal  use  of  testing  carry  the  potential  for  adverse  effects  of  unnecessary  investigations.