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2021 Chest Pain Guidelines

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2 Key Points Scope of the Problem Synopsis ➤ After injuries, chest pain is the second most common reason for adults to present to the emergency department (ED) in the United States and accounts for >6.5 million visits, which is 4.7% of all ED visits. ➤ Chest pain also leads to nearly 4 million outpatient visits annually in the United States. ➤ Chest pain remains a diagnostic challenge in the ED and outpatient setting and requires thorough clinical evaluation. • Although the cause of chest pain is often noncardiac, coronary artery disease (CAD) affects >18.2 million adults in the United States and remains the leading cause of death for men and women, accounting for >365,000 deaths annually. • Distinguishing between serious and benign causes of chest pain is imperative. • The lifetime prevalence of chest pain in the United States is 20% to 40%, and women experience this symptom more often than men. • Of all ED patients with chest pain, only 5.1% will have an acute coronary syndrome (ACS), and more than half will ultimately be found to have a noncardiac cause. • Nonetheless, chest pain is the most common symptom of CAD in both men and women.

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