Irish medical journal
-
A descriptive follow-up study of a hospital based chest pain clinic set up for the identification of the patients with unstable angina and acute myocardial infarction. The clinic is staffed by a cardiologist-in-training seeing patients on the day of referral by general practitioners because of acute chest pain of unclear origin. Over 6 months, 174 patients were assessed. 34 (19.5%) had a diagnosis of unstable angina or acute myocardial infarction (acute coronary syndrome), 52 (30%) had non-acute cardia pain and 88 (50.5%) had non-cardiac pain. ⋯ In the absence of the clinic, general practitioners would have arranged hospital admission for 66 (48%) or assessment in the emergency department for 13 (9%) of those discharged. Almost all general practitioners found the service helpful. The chest pain clinic was well received and provided an efficient method of identifying patients with acute coronary syndrome and minimised unnecessary admissions.
-
Aortic stenosis is common in the elderly. Basal systolic murmurs are also common. We studied 512 patients over the age of 65 years to ascertain the prevalence of basal systolic murmurs and by using echocardiography on those with basal murmurs to determine the prevalence of significant aortic stenosis. 29% (148) of patients had basal systolic murmurs. 81 (55%) patients of this group had echocardiography carried out and 21 (25.9%) had a gradient across the aortic valve of 30 mmHg or more.