Chest Pain Management In The Emergency Department By Attending Physicians: A Cross-Sectional Study

Abstract

Background: Chest pain is a frequent presentation in emergency departments, often indicative of serious conditions like acute coronary syndrome. Effective management in this context requires prompt and accurate assessment to ensure timely intervention. Despite its critical importance, there is a lack of consensus on the optimal approach to chest pain management, prompting the need for empirical investigation into the practices and decision-making processes of attending physicians in this setting.

Methods: This was a cross-sectional study involving a survey of attending physicians in emergency departments. The survey consisted of questions about demographics, practice patterns, and management of chest pain patients. The data collected was analyzed using descriptive statistics and inferential statistics. The sample consisted of attending physicians working in emergency departments. A convenience sample was used and physicians were recruited through email and social media or face to face.

Results: This cross-sectional study involving 103 physicians explored chest pain management practices in the emergency department. The participants' demographics revealed a predominantly male cohort (71.8%), with an average age of 31.4 years and a median experience of 3 years. Table 2 illustrated the prominence of chest pain cases, with 69.9% of physicians encountering them "Almost always." Their initial assessment strategies exhibited a preference for comprehensive evaluation (78.6%) involving clinical assessment, ECG, chest X-ray, and blood tests. Most physicians (83.6%) favored a comprehensive diagnostic approach. Noteworthy attitudes emerged in Table 3, as 81.5% expressed confidence in diagnosing chest pain, and 69.9% and 26.2% considered systematic management "Very important" and "Important," re[1]spectively. Risk stratification tool usage was substantial (81.6%). The  associations between demographic factors and outcomes was examined, suggesting nuanced gender, age, experience, and specialty influences on management practices.

Conclusion: Research findings underscore the prominence of chest pain cases in the emergency department and reveal a preference for comprehensive assessment and diagnostic approaches. Physicians express confidence in diagnosis and emphasize the significance of systematic management. The substantial utilization of risk stratification tools highlights a commitment to evidence-driven care. Demographic factors exhibit nuanced associations with management practices. This study offers valuable insights into contemporary chest pain management and underscores the need for continued research in this vital clinical domain.