In general practice, chest pain is a very common clinical complaint. The general practitioner’s decision to refer a patient to hospital is mainly based on chest pain characterization, patient's cardiovascular history, as well as electrocardiographic and hemodynamic changes. Acute coronary syndrome (ACS) remains the main diagnostic challenge. In this case, a coronary angiography must generally be performed, but the delay will depend on the type of ACS. ST-segment elevation myocardial infarction (STEMI) requires rapid transport to the emergency room, given that the time to reperfusion (time span from diagnosis to coronary reperfusion, ideally <60 min) determines the patient’s prognosis. Patients with non-ST segment infarction (NSTE-ACS) should undergo angiography within 24 to 72 hours. Platelet inhibitors (aspirin and P2Y12 receptor inhibitors) are the cornerstone of pharmacological treatment. They are generally administered over 1 year. Beyond initial diagnosis, the general practitioner also plays a crucial role in ensuring continuity of care following hospitalization, since these patients are at high risk of relapse.
Chest pain, acute coronary syndrome