ACEP CME: Chest Pain

A new continuing education activity from the American College of Emergency Physicians (ACEP): Focus on Chest Pain.

We all know what to do for the patient whose pain is described as a crushing pressure in the middle of his chest radiating to his left arm, associated with diaphoresis and shortness of breath. However, many patients present with a hodgepodge of "atypical features" that require the emergency physician to balance high-risk and low-risk features. And what about other life threats? Aortic dissection and pulmonary embolism are two notoriously tricky diseases that may present in a variety of ways.

While it has been consistently shown that history alone cannot rule out these life threats altogether,1-4 it does allow an emergency physician to determine the optimal plan of treatment and disposition. To do this well, the emergency physician must know which features indicate higher risk and not be lulled into a false sense of security by one reassuring feature. This article will highlight the most important features of the patient history for chest pain from recent literature.