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Chest pain

Causes
Clinical features
Investigations
Therapy
Prognosis
Clinical features

Ask about any associated nausea or vomiting b

Why?

Nausea and vomiting 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
attending emergency department with chest pain b
(pre-test probability: 20%) 		myocardial infarction
(ECG and cardiac enzyme changes) 		nausea or vomiting 1.9
(1.7 to 2.3) 		32%
 
anterior chest pain b
(pre-test probability: 12%) 		myocardial infarction
(cardiac enzymes, ECG) 		history of associated nausea 1.9
(1.4 to 2.4) 		21% 0.63
(0.47 to 0.84) 		8%

 

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