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International Journal of
Cardiology

Chest pain centers: moving toward proactive acute coronary care

Raymond D. Bahr MD
Paul Dudley White Coronary Care System
St. Agnes Healthcare
Wilkens & Pine Heights Avenue
Baltimore, MD 21229, USA

+1-410-368-3200
fax: +1-410-368-3207
email: rbahr@ehac.org (R.D. Bahr)

Received 12 March 1999;
received in revised form 1 September 1999;
accepted 4 September 1999


Abstract

Ischemic heart disease is the major cause of death, disability and lost productivity in the developed countries of the world. The evolution of cardiac care units has improved patient survival from myocardial infarctions, but requires a high-tech, very expensive treatment facility. Chest pain centers, located in emergency departments, present an efficient alternative to triage patients with chest pain, providing prompt and accurate diagnosis, risk evaluation and appropriate treatments. Hospitals benefit from this cost-effective approach as resources are used more efficiently, and patients benefit from a supportive treatment facility that focuses on early intervention. Early recognition of prodromal unstable angina symptoms and intercession with newly developed treatment can help move the cardiologist toward a more proactive role that minimizes or avoids myocardial infarctions rather than reacting to the acute event. © 2001 Elsevier Science Ireland Ltd. All rights reserved.

Keywords: Ischernia; Myocardial infarction; Prodroma; Unstable angina; Chest pain


Table of Contents

Introduction
History of coronary care in the United States
Development of chest pain centers
Treatment protocols for chest pain patients
Patient education
Medical outcomes
Economic outcomes from chest pain centers
Conclusion
References


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