Diagnostic Performance of Emergency Department Assessment of Chest Pain Score

Acute Chest Pain

This study aims to evaluate whether EDACS performed during triage to assess patients with chest pain could improve the predictive validity of triage for an acute cardiovascular event.

Chest pain is common reasons for presentation to the emergency department (ED).Up to 6.3% of emergency department (ED) visits are related to chest pain. Causes of chest pain range from musculoskeletal chest pain to potentially life-threatening emergencies as acute coronary syndrome(ACS), aortic dissection or pulmonary embolism. Therefore, accurate and fast risk stratification is paramount in the acute management, mainly to identify those patients with immediate risk of complications, as those with an ACS. Those patients are challenging to discriminate, as there is a variety of clinical manifestations. Chest pain is considered to be an acute chest pain, described as pain, pressure, tightness, or burning as outlined in the guidelines Chest pain equivalent symptoms may include dyspnea, left arm, and epigastric pain. Triage helps recognize the urgency among patients. An accurate triage decision helps patients receive the emergency service in the most appropriate time. Various triage systems have been developed and verified to assist healthcare providers to make accurate triage decisions. Despite good levels of specificity, the available triage systems appear to have suboptimal sensitivities that cannot adequately prioritize patients with acute cardiovascular diseases. The Emergency Department Assessment of Chest Pain Score (EDACS), through a standardized assessment of the patient's history and presenting symptoms only, provides good levels of sensitivity in stratifying time dependent acute cardiovascular diseases. The good discriminatory ability of EDACS, combined with its easy clinical applicability, could be used to overcome some of the limitations of triage systems in assessing chest pain.

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