Chest pain

Chest pain is a common symptomfor which patients present to their primary care provider. Patients with acute chest pain pose a diagnostic challenge for the general practitioner since a wide range of diagnoses are possible, ranging from life-threatening acutemyocardial infarction and pulmonary artery embolism to the far more frequent and harmless muscular tension belonging to the group of chest wall syndromes, as well as gastrointestinal causes such as gastroesophageal reflux disease. The clinical evaluation of patients with acute chest pain is based on a thorough clinical assessment by the physician, including a physical examination and medical history, irrespective of the location of the examination. This is followed by further technical examinations, such as a 12-lead electrocardiogram, and targeted laboratory diagnostics with point-of-care tests, including troponin and D-dimer tests. Diagnostic pathways and score systems, such as the Marburg Heart Score, have been specially developed to enable patient assessment and provide orientation in the primary care setting.