• Luis F Pastor Torres, Ricardo Pavón-Jiménez, Margarita Reina Sánchez, Jorge Caparros Valderrama, and José A Mora Pardo.
• Servicio de Cardiología. Hospital Universitario Virgen de Valme. Sevilla. España. lpastortorres@eresmas.com
• Rev Esp Cardiol. 2002 Oct 1;55(10):1021-7.

Introduction And ObjectivesIn Spain there is little information available about chest pain units for the treatment of patients of low-to-medium risk with suspected acute coronary syndrome.Patients And MethodA prospective study was performed among emergency room patients who complained about acute chest pain and were suspected of suffering an acute coronary syndrome with a normal or unspecific initial evaluation. They underwent an early submaximum stress test to decide on possible hospitalization. The follow-up time was 1 year.ResultsOf 472 emergency room patients with suspected acute coronary syndrome, 179 performed the stress-test during the first hours of the triggering chest pain episode. None met the high-risk criteria for unstable angina. In 78.8% of the cases, the test results were negative and the patients were discharged. The results were positive in 15.1% and inconclusive in 6.1%; there were no complications during the procedure. Patients with a negative stress test had a more favorable outcome than the rest, with fewer following visits to the emergency room (11% vs 22%, p<0.001). One patient with a negative stress test died of a non-cardiovascular complication. None of the patients suffered acute myocardial infarction during follow-up and 89% of the patients with negative stress test had a favorable outcome (in terms of visits to the emergency room, unstable angina, acute myocardial infarction, or cardiovascular death).ConclusionsChest pain units for the care of low-to-medium risk patients with acute chest pain allow a fast and safe hospital release with a favorable mid-term outcome.

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