Chest Pain in Patients Seen in Emergency Clinics

CAUSES of chest pain are diverse and numerous. The chest contains many structures. Not only can disease of any of these structures produce pain in the chest, but also pain originating elsewhere in the body, particularly in the gastrointestinal tract, may be referred to the chest. Longlasting pain or brief episodes of chest discomfort are the two patterns of pain that usually cause emergency clinic visits. Either pattern may be caused by benign or life-threatening conditions, but persistent severe pain, particularly if associated with objective evidence of disease, such as fever, tachycardia, or the appearance of shock, points toward a serious organic condition. Much more important than the duration of the pain or even its quality are its mode of onset and factors that incite, affect, or relieve it. Although radiation of the pain to the left arm is frequently considered by both patient and physician as particularly ominous and