Severe Chest Pain Does Not Herald Worse Outcomes

In a large study of patients presenting with chest pain, severity of pain did not predict acute myocardial infarction, death, or revascularization.

Patients — and textbook authors — often believe that severe chest pain is more likely to indicate heart attack than is milder chest pain. Researchers conducted a secondary analysis of a prospective study of 3306 patients with chest pain who presented to an academic emergency department (ED) in Philadelphia from 2005 through 2009. Severity of chest pain was scored on a scale from 0 (no pain) to 10; scores of 9 to 10 were deemed severe, and scores of 1 to 8 were deemed nonsevere. Outcomes were acute myocardial infarction (MI) diagnosed in the ED and the composite of death, acute MI, or revascularization within 30 days.

Severity of chest pain was not significantly associated with acute MI or the composite outcome, either when patients with seve…

Reviewing Author

Daniel J. Pallin, MD, MPH

Disclosures

Consultant/Advisory BoardPortola Pharmaceuticals, Inc.

Speaker’s BureauPeerView Institute for Medical Education

Grant/Research SupportAgency for Healthcare Research and Quality; CDC; NIH–National Center for Advancing Translational Sciences; NIH–National Institute of Allergy and Infectious Diseases (NIAID); NIH–NIAID–Antibacterial Resistance Leadership Group; Merck; Pfizer; Boehringer-Ingelheim; Shire; Portola Pharmaceuticals, Inc.; Novartis; bioMérieux; Siemens; Rapid Pathogen Screening; Magnolia; Stago; Innovative Biosensors; Molecular Detection, Inc.; Dyax Corp.; Trius Pharmaceuticals

Daniel J. Pallin, MD, MPH

Disclosures

Consultant/Advisory BoardPortola Pharmaceuticals, Inc.

Speaker’s BureauPeerView Institute for Medical Education