According to an article on the current issue of Heart are chest pain patients almost two thirds of the patients who are admitted to hospital in emergency care units. But, only a fraction of them probably warrant it on the basis of subsequent tests, suggest the researchers.

Around 15 million people seek emergency care in England and Wales every year, and it had been thought that chest pain accounted for around 2.5% of this workload, roughly 360,000 cases.

But the study of activity in the emergency department of Northern General Hospital, Sheffield, suggests that it is more likely to be 700,000 cases, equivalent to 6% of the workload.

The researchers analysed all attendances for emergency care on account of chest pain at the hospital between February 2001 and May 2002. Specialist nurses categorised the patients into cases of definite or probable serious heart problems, life threatening disease - such as a blood clot in the lung or pneumonia -, little risk of serious heart problems, and anything else not covered by the other four categories.

During the study period, chest pain or a related complaint accounted for just under 7,000 of the 115, 620 visits by adults to the emergency department (6% of the workload). And it also accounted for around one in four of all medical admissions (4,438 or just over 27%).

Two thirds of patients with chest pain were admitted, yet only a minority had a definitive diagnosis on ECG of serious heart problems. Around one in three of those attending the emergency care department, and half of those admitted, did not have clear ECG changes.; Source: Heart - BMJ Journals