PT  - JOURNAL ARTICLE
AU  - Nils Hoyer
AU  - Ida Steffensen
AU  - Mikkel Schoos
AU  - Martin Schonemann-Lund
AU  - Rolf Steffensen
TI  - Standard chest radiographs in patients admitted for evaluation of acute coronary syndrome may contribute to early recognition of pulmonary disease, an observational study
DP  - 2014 Sep 01
TA  - European Respiratory Journal
PG  - P649
VI  - 44
IP  - Suppl 58
4099  - http://erj.ersjournals.com/content/44/Suppl_58/P649.short
4100  - http://erj.ersjournals.com/content/44/Suppl_58/P649.full
SO  - Eur Respir J2014 Sep 01; 44
AB  - BackgroundThe usual primary evaluation in patients with acute non-traumatic chest pain is investigation for signs of ischemic heart disease in a coronary care unit. Frequently, standard chest radiograph (CXR) is obtained in order to rule out differential diagnoses and complications. A high prevalence of lung disease may be suspected, even if acute coronary syndrome (ACS) is ruled out, since both symptoms and risk factors for lung disease and heart disease are overlapping.AimTo investigate the occurrence of radiologic signs of lung disease in patients admitted with non-traumatic chest pain, and to evaluate whether such findings subsequently led to further pulmonary examination.Methods244 randomly selected patients under evaluation for ACS were included in this observational study. Demographic, clinical and successive follow up data were extracted from charts. Patient CXRs were scored independently by 2 trained investigators.Results136 patients were discharged with no definitive diagnosis of heart disease. Radiologic signs of lung disease on CXR (new opacity, fibrosis, hyperinflation and coarse bronchovascular markings) were detected in 84 of these patients. Twenty-six patients previously had a known pulmonary condition and received treatment. Of the remaining 58 patients (69%), who were eligible for further evaluation, only a minority were referred to pulmonary examination.ConclusionsIn the setting of acute non-traumatic chest pain and a primary suspicion of ACS, a routine standard chest radiograph may be recommended, since it holds the potential of early recognition of lung disease in many patients.