Chest pain unit in an internal medicine department: comparison of a year with the facility to a year without.

c hest pain is a common complaint and one of the leading causes of emergency department visits. It is considered the second most common etiology for ED1 visits after abdominal pain, and is estimated to account for 5%–9% of the ED visits and for the high rates of hospital admissions in the western world [1-7]. Data from the United States suggest that 2.1% of ED patients with acute myocardial infarction and 2.3% with unstable angina pectoris are missed [8]; these cases constitute both a medical and a legal burden [9] and force clinicians to perform investigations even in low risk patients [10]. Advanced medical imaging testing is often necessary to diagnose as well as rule out serious medical conditions associated with these symptoms [11,12]. The etiology of chest pain can be non-cardiac, including diseases of the respiratory system (infections, tumors, inflammatory processes, pneumothorax) and of the musculoskeletal system (costochondritis, intercostal neuralgia, bone lesions, or traumatic). Chest pain of cardiac origin could be due to either ischemic events (acute coronary syndrome, angina pectoris, myocardial infarct) or non-ischemic (pericardial disease, myocarditis, cardiomyopathies). Patients with chest pain of intermediate probability for ischemic cardiac origin are of special interest. These patients need to be admitted to cardiology or internal medicine departments for additional investigation regarding the cause of the chest pain and for appropriate treatment. They are usually ED = emergency department hospitalization period. CPu is an effective facility for rapid and effective investigation of patients admitted with chest pain. IMAJ 2013; 15: 79–84 chest pain unit, ischemic heart disease, invasive cardiac procedures, length of hospitalization KeY wOrds: