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Submitted: 02 June 2007
HERDIN Record #: PCHRD060107080614

Clinical features of emergency department patients presenting with symptoms suggestive of acute coronary syndrome: The Philippine Heart Center experience .

Noel R. Lamorena,
Myra Consolacion Dolor-Torres

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BACKGROUND: Identification of patients with acute coronary syndrome syndrome (ACS) remains challenging. The object of this study was to examine the role of clinical findings in die diagnosis of emergency department (ED) patients with symptoms suggestive of ACS.

METHODOLOGY: This a prospective and descriptive study over a 6 month period (June 2004-November 2004)of cases seen at the Philippine Heart Center. Study population included cases of all ACS and suspected ACS seen at the ED.

RESULTS: The results indicated that ACS patients were more likely to have chest pain as a chief complaint or presenting symptom (P=0.001). The presenting symptom of fainting was more commonly associated with a final diagnosis of ACS (P=0.001). Chief complaint and presenting symptoms of abdominal pain, nausea, and dizziness were less frequent among patients with a final diagnosis of ACS (P=0.001). A past history of diabetes mellitus, myocardial infarction, or angina pectoris was more frequently
associated widi a final diagnosis of ACS (P=0.001).A lower pulse rate in patients with a final diagnosis of ACS (P=0.001) was not considered clinically significant. All primary ST-segment abnormalities, Q waves, andT-wave abnormalities, except T-wave flattening, were seen more frequently in patients with a final diagnosis ACS (P=0.001). Normal ECGs were more frequently associated with a non-ACS final diagnosis, yet 20 percent of AMI patients and 37 percent of Unstable Angina (UA) patients had normal ECGs.

CONCLUSION: It can be concluded that certain clinical features can help identify ED patients with ACS. Initially normal ECGs can be seen in 20 percent of patients with AMI and 37 percent of patients with UA. Patients with ACS could also present with "normal" blood pressures.

Publication Type
Journal
Publication Sub Type
Journal Article, Original
Title
Philippine Journal of Cardiology
Frequency
Quarterly
Publication Date
October-December 2005
Volume
33
Issue
4
Page(s)
179-187

Objectives

To examine the role of clinical findings in the diagnosis of emergency department (ED) patients with symptoms suggestive of acute coronary syndrome (ACS).

LocationLocation CodeAvailable FormatAvailability
Philippine Council for Health Research and Development Library Abstract Print Format (Request Document)