• Julián Bayón Fernández, Eduardo Alegría Ezquerra, Xavier Bosch Genover, Adolfo Cabadés O'Callaghan, Ignacio Iglesias Gárriz, José Julio Jiménez Nácher, Félix Malpartida De Torres, Ginés Sanz Romero, and Grupo de Trabajo ad hoc de la Sección de Cardiopatía Isquémica y Unidades Coronarias de la Sociedad Española de Cardiología.
• Servicio de Cardiologia, Hospital de Leon, Avda, Spain.
• Rev Esp Cardiol. 2002 Feb 1; 55 (2): 143-54.

AbstractThe two main goals of chest pain units are the early, accurate diagnosis of acute coronary syndromes and the rapid, efficient recognition of low-risk patients who do not need hospital admission. Many clinical, practical, and economic reasons support the establishment of such units. Patients with chest pain account for a substantial proportion of emergency room turnover and their care is still far from optimal: 8% of patients sent home are later diagnosed of acute coronary syndrome and 60% of admissions for chest pain eventually prove to have been unnecessary.We present a systematic approach to create and manage a chest pain unit employing specialists headed by a cardiologist. The unit may be functional or located in a separate area of the emergency room. Initial triage is based on the clinical characteristics, the ECG and biomarkers of myocardial infarct. Risk stratification in the second phase selects patients to be admitted to the chest pain unit for 6-12 h. Finally, we propose treadmill testing before discharge to rule out the presence of acute myocardial ischemia or damage in patients with negative biomarkers and non-diagnostic serial ECGs.

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