EM - Original

Internal and Emergency Medicine

, Volume 5, Issue 5, pp 427-432

First online:

The prevalence of the cardiac origin of chest pain: the experience of a rural area of southeast Italy

  • Chiara CiliaAffiliated withUnit of Internal Medicine, University of Catania
  • , Lorenzo S. MalatinoAffiliated withUnit of Internal Medicine, University of Catania Email author 
  • , Giuseppe PucciaAffiliated withUnit of Internal Medicine, University of Catania
  • , Maria Anna IuratoAffiliated withEmergency Department, Civil Hospital
  • , Giovanni NotoAffiliated withEmergency Department, Civil Hospital
  • , Giovanni TripepiAffiliated withCNR-IBIM
  • , Peter RosenAffiliated withEmergency Medicine, Harvard Medical School
  • , Benedetta StancanelliAffiliated withUnit of Internal Medicine, University of Catania

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This study was designed to assess the application of diagnostic guidelines to the management of chest pain by an observational study carried out in a small town (Ragusa) of southeast Sicily. This study was an attempt to compare a Sicilian experience with the literature. In this observational study, we examined all the patients referred for chest pain to the Emergency Department (ED) of “Civile-M. P. Arezzo” Hospital during a period of 6 months (from January 1st 2008 to June 30th 2008). As much as 857 patients were studied. The results of our study show that musculoskeletal chest pain is the most common final diagnosis (49%), followed by cardiac chest pain (26.3%), gastrointestinal chest pain (13%), pulmonary chest pain (7%) and psychiatric chest pain (4%). The majority of patients (95%) never made contact with their primary care providers, and came straight to ED. These results emphasize the need for reworking a strategy to avoid the situation in which all cases of non-emergency chest pain, such as musculoskeletal ones, come to the hospital for evaluation, thereby overwhelming the ED, particularly in rural areas where the management of any emergency is centralized in a single hospital.


Chest pain Emergency department General practice Emergency care management