Diagnostische Strategien in der frühhospitalen Abklärung des akuten Thoraxschmerzes: Arbeitsgruppenpapier der AG 44 Akuter Thoraxschmerz

Currently, most of the procedures and diagnostic algorithms in the current German chest pain unit certification criteria focus on the investigation of ischemic causes of chest pain. Noncardiac causes are insufficiently covered. Other differential diagnoses, which are also associated with increased mortality are less frequently considered. Because the primary symptom of acute chest pain is the critical criterion for the initial triage, regardless of the cause, a symptom-driven, patient-centered approach is proposed. The main focus of this patient-centered algorithm is the rapid differentiation between potentially acutely life-threatening cardiac and noncardiac and non-acutely life-threatening causes, depending on the risk constellation of the acute chest pain. Chest pain units should have local standards that include the recognition of potentially life-threatening nonischemic or extracardiac causes. In this context, further efforts must be made to raise public awareness of the need to act quickly in the event of symptoms of acute chest pain, possibly supplemented by dedicated bystander teaching and certification tools.