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Chest pain

Causes
Clinical features
Investigations
Therapy
Prognosis
Clinical features

Look for a third heart sound b

Why?

A third heart sound make a myocardial infarction more likely

Patient Target Disorder and
Reference Standard		 Diagnostic Test LR+
(95% CI) 		Post-test Probability LR-
(95% CI) 		Post-test Probability
anterior chest pain b (pre-test probability: 12%) myocardial infarction
(cardiac enzymes, ECG) 		third heart sound on auscultation 3.2
(1.6 to 6.5) 		31% 0.88
(0.79 to 0.99) 		11%

 

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

Author   CM   Ball
Reviewer   S   Straus
CAT Writers   CJ   Wotton , CM   Ball , N   Shenker , RS   Phillips