Quote from getoverit
what about unremitting chest pain caused by esophageal vasospasms? or costochondritis?
an incomplete assessment and workup can overlook things like that. even though ntg has been documented to alleviate cp from non-cardiac sources, but it hasn't worked at least as many times as it has in those cases.
i'm not arguing with you, just highlighting how many different potential reasons there could be that a) have nothing to do with your heart and b) don't need a cath lab to diagnose.
the OP was discussing patients admitted to a coronary care unit...which means they have made it there on the basis of CP PLUS one of the following- ECG changes, enzymes, angina hx, family hx, or risk factors (to name a few). That is the context of the question.
yes you are free to tease out the multiple causes of noncardiac CP but the OP refers to a pt in a coronary unit, which means they have moderate to high probability.
In real world practice these pts will be admitted and cathed. There is a reason we have so many clean caths- b/c no pretest probability is 100% sens/spec. If it was we'd all (hopefully) be paying lower health insurance premiums.
A cardiologist with a patient who has any of the above mentioned hx/profile and unremitting CP is likely NOT going to sit on them, expose themselves to a neg outcome and liability b/c the pt might have costochonditis. Pts in the coronary unit have already had the "complete assessment and w/u". No w/u is 100% but that is why we study the statistics on these tests in the first place...