Characteristics, types and causes of chest pain in an urban family practice secondary care center in South India

Background. Chest pain is a common diagnostic problem faced by primary and emergency care physicians. We are taught to consider the cardiac cause of chest pain as the usual cause from our undergraduate textbooks. Though the cardiac cause of chest pain is one of the more serious causes, it may not be the common one. There was a paucity of data available concerning this common problem in the Indian context. We present an observational study of causes of chest pain in 254 adults presenting to an ambulatory secondary care unit. Material and methods. All consecutive adults (over 18 years of age) presenting with chest pain to the urban family health center were administered a questionnaire documenting location, severity, characteristic and cause of chest pain as diagnosed by relevant clinical examination and appropriate investigations. This was done in the time period from September 2014 to July 2016. Results. A total of 254 adults with chest pain were studied, among whom 73.6% (187) were female. The most common diagnosis as to the cause of chest pain made by the treating physician was of a gastro-esophageal cause (41.3%, 105). A cardiac origin of chest pain was diagnosed in 18.5% (47) of the patients. Conclusions. The causes of chest pain in adults vary with the setting and the target population. It is mostly non-cardiac in ambulatory care practices in primary and secondary care units. However, we need to be clinically vigilant and apply a robust approach in diagnosing chest pain.