Chest Pain Units

The chest pain unit is a recent development in emergency medicine that specifically caters for patients with low risk chest pain.

The unit provides protocol-driven care, often by specialist chest pain nurses, to rule out AMI and then estimate the risk of coronary heart disease.

Patients with low risk chest pain receive rapid cardiac marker testing with CK-MB (mass) gradient and/or myoglobin gradient and/or troponin to rule out AMI. Following this, they may undergo immediate, or early, exercise treadmill testing.

Do chest pain units work?

The chest pain unit has been shown to improve outcomes for patients with low risk chest pain, and to reduce costs by reducing hospital admissions and subsequent scheduled ,and unscheduled, hospital care.

However, successful implementation of chest pain unit care appears to depend upon a number of organisational factors. If these issues are not addressed, then establishing a chest pain unit may simply attract more attendances with chest pain, only manage a highly selected minority of patients, and, paradoxically, end up increasing admissions.