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 early treatment."
"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.