Document Detail


Chest pain and ischaemic heart disease in primary care.
MedLine Citation:
PMID:  12830565     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Chest pain is the main symptom of first presentation with ischaemic heart disease (IHD). Little is known about the incidence of IHD among patients consulting the general practitioner (GP) for chest pain. AIMS: To estimate the occurrence of IHD among patients consulting for chest pain, to study the results of the bicycle exercise test, and to estimate the incidence of IHD in the population. DESIGN OF STUDY: Prospective descriptive study. SETTING: Three primary health centres in south-eastern Sweden. METHOD: All patients without a current IHD diagnosis, aged 20 to 79 years, and consulting for a new episode of chest pain, were included consecutively. The outcome was classified as IHD, possible IHD or not IHD, according to the results of a postal questionnaire, an exercise test or hospital care. Data from the hospital registry on patients with a diagnosis of IHD were analysed retrospectively. RESULTS: Out of 38,075 GP consultations, 577 (1.5%) were for chest pain. IHD was diagnosed in 41 (8%) of the chest pain patients, in 441 (83%) the diagnosis was excluded, and in 50 (9%) the diagnosis was judged as being uncertain. Even though the diagnostic criteria were strict, the exercise tests led to a diagnostic conclusion in 77% of the cases, most frequently a normal test result. Combining data from primary and hospital care, the yearly incidence of IHD was 6.5 diagnosed per 1000 inhabitants (aged 20 to 79 years old). CONCLUSION: The incidence of a new episode of chest pain bringing the patients to the GP was low. Eight per cent of the patients received an IHD diagnosis, and in 9% further investigation or clinical assessment is needed.
Authors:
S Nilsson; M Scheike; D Engblom; L G Karlsson; S Mölstad; I Akerlind; K Ortoft; E Nylander
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The British journal of general practice : the journal of the Royal College of General Practitioners     Volume:  53     ISSN:  0960-1643     ISO Abbreviation:  Br J Gen Pract     Publication Date:  2003 May 
Date Detail:
Created Date:  2003-06-30     Completed Date:  2003-08-27     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  9005323     Medline TA:  Br J Gen Pract     Country:  England    
Other Details:
Languages:  eng     Pagination:  378-82     Citation Subset:  IM    
Affiliation:
Department of General Practice and Primary Care, Faculty of Health Sciences, University of Linköping, Sweden. staffan.nilsson@lio.se
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Chest Pain / epidemiology*
Emergencies
Emergency Medical Services / methods
Exercise Test / methods
Family Practice / statistics & numerical data*
Humans
Middle Aged
Myocardial Ischemia / diagnosis,  epidemiology*
Prospective Studies
Questionnaires
Referral and Consultation
Sweden / epidemiology
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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