Chest pain in primary care: Epidemiology and pre-work-up probabilities

Figures & data

Figure 1. Patient recruitment.

Table I. Final diagnoses in patients presenting with chest pain to their GP (n = 1212).

Diagnosis	Frequency (n = 1212)	% (95% CI)
Chest wall syndrome	565	46.6 (43.8–49.5)
Ischaemic heart disease (stable)	135	11.1 (9.4–13.1)
Psychogenic disorders	115	9.5 (7.9–11.3)
Upper respiratory infections	98	8.1 (6.6–9.8)
Hypertension*	48	4.0 (2.9–5.2)
Acute coronary syndrome	44	3.6 (2.7–4.8)
Gastro-oesophageal reflux disease	42	3.5 (2.5–4.7)
Trauma	39	3.2 (2.3–4.4)
Benign stomach problems	26	2.1 (1.4–3.1)
Pleuropneumonia	25	2.1 (1.3–3.0)
COPD/asthma	23	1.9 (1.2–2.8)
Other	52	4.3 (3.2–5.6)

*Patients presenting with hypertensive urgency in whom chest pain consequently subsided when blood pressure was lowered. CI: confidence interval; COPD: chronic obstructive pulmonary disease.

Figure 2. Aetiology of chest pain in relation to age, gender, and history of IHD (n = 1212).

Table II. Probabilities for any IHD (acute or chronic), by age and gender (n = 1212).

IHD or ACS
Age, years	Male % (n/total)	Female % (n/total)
<40	4.1 (2/49)	0.0 (0/47)
40–49	4.1 (5/122)	1.6 (2/128)
50–59	13.3 (16/120)	5.6 (8/143)
60–69	23.7 (28/118)	11.9 (18/151)
≥70	32.8 (41/125)	28.2 (59/209)

IHD: ischaemic heart disease; ACS: acute coronary syndrome.

Table III. Probabilities for any IHD (acute or chronic) in patients presenting with non-anginal and anginal chest pain, by age and gender (n = 1212).

	Non-anginal chest pain		Anginal chest pain*
Age, years	Male % (n/total)	Female % (n/total)	Male % (n/total)	Female % (n/total)
<40	4.4 (2/45)	0.0 (0/42)	0.0 (0/4)	0.0 (0/5)
40–49	3.6 (4/111)	0.0 (0/110)	9.1 (1/11)	11.1 (2/18)
50–59	10.7 (11/103)	3.8 (5/131)	29.4 (5/17)	25.0 (3/12)
60–69	17.0 (16/94)	7.7 (9/117)	50.0 (12/24)	26.5 (9/34)
≥70	27.7 (31/112)	24.0 (42/175)	76.9 (10/13)	50.0 (17/34)

*Patients presenting with retrosternal and exertional chest pain. IHD: ischaemic heart disease.