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Chest pain is one of the most common reasons that patients present to the emergency department (ED). The underlying disease processes can range from benign to life-threatening. It is critical for the provider to thoroughly evaluate and risk-stratify patients who present with this complaint to reduce the chances of missing a potentially serious condition.
The purpose of this article is to discuss the diagnosis, treatment, and management of the common causes of chest pain that can present in a young adult.
Introduction
About 8 million people are seen in the United States every year for chest pain.1 In contrast to the population of elderly adults typically seen for chest pain in EDs, an increasing number of young men and women are evaluated for symptoms of acute chest pain every day.2 Many of these patients have no cardiac risk factors. The prevalence of acute coronary syndrome has been found to be around 1% in people younger than 40 years of age, and the prevalence is about 5-10% in those younger than 50 years of age.3 Therefore, ED providers must be aware of the various other causes of chest pain in the young population.
Chest pain can be caused by a variety of disease processes that can range from benign to life-threatening. Although protocols have been developed to consider every patient who presents with chest pain as a potentially serious condition based on acuteness, duration, and intensity of pain, these factors do not necessarily correlate with a life-threatening disorder. Providers often dismiss chest pain in the younger population because of the rare occurrence of significant morbidity and mortality. Patients who are evaluated for chest pain in the ED must undergo a thorough history and physical examination with proper diagnostic testing to avoid inappropriate patient evaluation, treatment, and disposition.
Evaluation of Chest Pain
In patients presenting to the ED with chest pain, the provider must perform a thorough history and physical examination to help guide the plan of care and treatment. It is imperative that the provider ask the proper questions and pay attention to key information obtained in the history, as this can assist with developing a broad differential diagnosis.4 In addition, being aware of the characteristics of the pain also can...