Assessment of chest pain in primary care: part 2

Assessment of chest pain in primary care: part 2

Chest pain is a commonly presenting complaint in general practice, and conditions causing chest pain or discomfort – such as acute coronary syndrome or angina – have a potentially poor prognosis. Although most chest pain will turn out to be non-cardiac in origin, it is imperative that due consideration is given in each case to exclude cardiac causes. Early and correct diagnosis of chest pain is important to ensure that patients receive appropriate and timely management of the condition. Cardiac chest pain does not always present in the same way and therefore it can be misleading, however the practice nurse is often the first point of contact for people with signs and symptoms of heart disease, and accurate assessment and history taking is essential.^1,2 NICE³ provides guidance of the identification of cardiac chest pain.

This resource, consisting of five assessment questions at advanced level, tests your understanding of the assessment of chest pain in general practice. Complete the resource, including reading the featured articles and undertaking some or all of the activities, to obtain a certificate for one hour of continuing professional development to include in your annual portfolio.

Aims and objectives

On completion of this module you should have an understanding of:

• The presentation and actions to take when a person presents with acute chest pain
• The symptoms of typical, non typical chest pain and other chest pain
• The role of ECGs in the diagnosis of cardiac chest pain
• When to refer for specialist input
• The role of Coronary Artery Risk Scoring

References

1. Cardiovascular Disease Outcome Strategy: Improving Outcomes for people with or at risk of cardiovascular disease. Department of Health, 2012 https://www.gov.uk/government/publications/improving-cardiovascular-disease-outcomes-strategy

2. Assessing Chest Pain in Primary Care Beverley Bostock-Cox.

3. NICE CG95 Chest Pain of Recent Onset; 2010 (updated 2016) https://www.nice.org.uk/guidance/cg95