Chest pain in adults : triage

Chest pain in adults is a complex and multifaceted symptom that presents a significant diagnostic challenge in both primary care settings and emergency departments. Its aetiology spans a broad spectrum, ranging from benign and self-limited conditions, such as chest wall pain, to serious disorders, including anxiety disorders, and extends to life-threatening conditions like unstable angina, aortic dissection, and pulmonary embolism. The critical task for healthcare providers is to accurately identify the underlying cause of chest pain, ensuring that life-threatening and serious conditions are promptly recognized and treated without subjecting patients with less severe causes to unnecessary testing and treatment.

Understanding the pretest probability of various causes of chest pain is the cornerstone of clinical diagnosis. This necessitates a careful and methodical approach, given the potential lethality of some underlying causes. Chest pain can be broadly classified by its origin into cardiac and non-cardiac causes.