BACKGROUND : Chest pain is a common clinical syndrome. However, there is a paucity of African
studies describing the causes, prevalence, aetiology, and disposition of patients with chest
pain presenting in the emergency department (ED).
AIM : The aim of this retrospective descriptive study was to determine the prevalence, causes,
demographics, and disposition of all adult patients with the main complaint of chest pain
presenting at the ED of a regional hospital in South Africa.
METHODS : Records of all patients 18 years and older presenting with the complaint of chest
pain from 1 December 2011 through 10 April 2012 were assessed. A data collection sheet
capturing patient demographics and disposition from the ED was used. The diagnosis was
subdivided into groups: cardiovascular, respiratory, gastrointestinal, musculoskeletal,
psychiatric/psychogenic, other, and unknown.
RESULTS : Of the 312 patients presenting with chest pain, 210 patient files were retrieved. The
prevalence of non-traumatic chest pain was 1.66%. Respiratory disease was the most common
cause (36.19%), with pneumonia the most common diagnosis (24.40%). Logistic regression
showed diagnoses of acute cardiovascular disease or respiratory disease, older age, and
transport by ambulance as being associated with admission.
CONCLUSION : The main cause of acute chest pain was found to be respiratory disease,
followed by musculoskeletal disorders. In the African context, the aetiology of acute chest
pain differs from that in first world countries. Health workers should therefore pay special
attention to respiratory conditions during diagnosis and management in African patients
with acute chest pain.