Critical pathways for evaluation of chest pain and breathlessness

Abstract

Acute onset of chest pain and breathlessness commonly heralds life-threatening clinical emergencies. A systematic approach to evaluation of these symptoms by the physicians who perform the initial evaluation of such patients could facilitate making the diagnosis of acute myocardial infarction, pulmonary embolism, aortic dissection and acute pericarditis with tamponade, thus averting the ominous prognosis associated with these diagnoses. Clinical profiling using elements obtained from a thorough history and examination coupled with the results of screening tests helps to triage patients that require urgent transfer to centers with the resources needed to confirm the diagnosis. Modern imaging is invariably required to confirm the diagnoses and monitor therapy.