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Chest pain

Causes
Clinical features
Investigations
Therapy
Prognosis
Prognosis

The risk of dying is increased with an elevated CK-MB a or troponin  a b

Why?

Elevated cardiac enzymes increases the risk of dying or having cardiovascular complications

Patient Prognostic Factor Outcome CER OR
(95% CI)		 NNF+
(95% CI)
chest pain suggestive of ischaemic heart disease b troponin I or T 2 mcg/l or more within 24 hours
independent 		death or MI
at 7 months 		5.9% 2.5
(2.0 to 3.1)		 13
(10 to 19)
    death
at 7 months 		1.6% 3.1
(2.3 to 4.1)		 31
(22 to 50)

 

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