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Acute coronary syndrome

Prevalence
Clinical features
Differential diagnosis
Investigations
Therapy
Prevention
Prognosis
Clinical features

Look for chest pain that is reproduced on palpation a b  

Why?

Pain reproduced on palpation makes unstable angina or a myocardial infarction less likely

Patient Target Disorder and
Reference Standard		 Diagnostic Test LR+
(95% CI) 		Post-test Probability
central or left-sided chest pain
(pre-test probability: 41%) a 		MI or unstable angina
(ECG, cardiac enzymes, stress tests) 		pain reproduced by chest-wall palpation 0.11
(0.057 to 0.21) 		7%
    pain partially reproduced by chest wall palpation 0.43
(0.20 to 0.94) 		24%
    pain not reproduced by chest wall palpation 1.6
(1.4 to 1.7) 		53%

 

Expiry date: June 2003
Levels of Evidence used in grading these guides

Authors   CM   Ball , N   Shenker
Reviewer   I K   Jang
CAT Writers   N   Shenker , CJ   Wotton , CM   Ball , RS   Phillips