Chest Pain: Differentiating Cardiac from Noncardiac Causes

Abstract

plaints in the acute care setting. Major causes of acute chest pain include cardiac, gastroesophageal, musculoskeletal, and pulmonary conditions. Because heart disease is the leading cause of death in the United States,1 it is important to diagnose a cardiac etiology in patients presenting with acute chest pain. In addition, noncardiac causes of chest pain may be serious. Conducting a thorough history and physical examination remain the most important component in evaluating a patient presenting with acute chest pain despite the advances in medical technology. It is essential to obtain the characteristics of the pain, including its location, duration, radiation, and quality as well as any accompanying symptoms. This article discusses the key clinical signs that will help to differentiate the common causes of acute chest pain; an emphasis is placed on the history and physical examination.