Custom Chest Pain Centers Lure Patients in Early
Feb. 10, 2000 (Minneapolis) -- Specialized chest pain centers within
emergency departments may help prevent heart attack by encouraging patients to
have even mild chest discomfort evaluated, according to an article published
recently in the International Journal of Cardiology. Because these units
only diagnose and treat chest pain, they may be more inviting to patients than
a conventional emergency department, writes author Raymond D. Bahr, MD.
"Chest pain centers provide a comprehensive management strategy for ...
chest pain patients," writes Bahr, the medical director of the Paul Dudley
White Coronary Care System at St. Agnes Healthcare Center in Baltimore. He is
also an instructor in medicine at Johns Hopkins Medical Institution. "Chest
pain centers also educate patients about symptoms and emphasize the benefits of
"Often the emergency department setting can be intimidating to a patient
with intermittent ... discomfort that may not yet feel truly painful," Bahr
tells WebMD. In the article, he writes that "[m]aking the chest pain
centers receptive to all chest pain patients, regardless of cardiac origin,
will increase the likelihood that patients will visit [the] centers 'just to be
safe,'" he writes. In the event that such a patient is in the early stage
of a heart attack, the risk of death can be cut in half, according to Bahr.
Chest pain centers are characterized by "'fast-track' [treatment
strategies], developed to rapidly and accurately [diagnose] and treat patients
with [a heart attack]," he writes.
"Chest pain centers clearly play a role in the ... treatment of patients
who may be having [a heart attack]," LeRoy E. Rabbani, MD, tells WebMD.
"This is one of many innovations that have pointed to the fact that
patients with chest pain should not treat those symptoms so lightly and should
present to the emergency department, particularly if they have risk factors for
coronary artery disease." He is the director of the coronary care unit at
Columbia-Presbyterian Medical Center in New York and assistant professor of
medicine at Columbia University College of Physicians and Surgeons.
"A chest pain center is a prompt and effective way to treat patients
[who are having a heart attack] and to avoid hospitalization if the patient
doesn't need it. The concept is being employed throughout the U.S. today,"
James T. Willerson, MD, tells WebMD. "If it's done well, it's an
appropriate and cost-effective way to treat patients. ... I'm all for chest
pain centers, and I think the review is a good one." Willerson is the
medical director of the Texas Heart Institute in Houston.
- Patients may be more comfortable going to a chest pain center than a
typical emergency room when they have mild chest discomfort.
- Earlier medical attention may help prevent people from going on to develop
an acute heart attack.
- Observers say such centers are useful in monitoring those who may be having
symptoms suggestive of a heart attack while avoiding admission into the
hospital if it's unnecessary.