Recognising and Responding to Life Threatening Emergencies

Acute Chest Pain

Latest Course update : January 2019

In approaching a patient with acute chest pain the focus of the initial assessment is on the early identification of life threatening disease. This is critical as early recognition will frequently enable early intervention reducing morbidity and mortality. In the patient presenting with acute chest pain there are 3 immediately life threatening conditions that should be considered :

• Acute Coronary Syndrome (ACS)

• Pulmonary Embolism (PE)

• Acute Aortic Dissection                          

Where the cause is not immediately obvious the aim is to exclude these life-threatening diseases. Once this is completed less serious causes for the patient’s symptoms should be considered including pneumonia, simple pneumothorax, pleurisy, pericarditis, oesophageal conditions and musculoskeletal causes.

It is often not possible to completely exclude serious disease in a patient presenting with acute chest pain and in these circumstances it becomes a matter of clinical judgment as to the potential risk that a patient’s condition is caused by serious disease or whether a benign cause is more likely.

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