Physical examination to exclude other VitaMove Back Pain Relief Review possible causes of chest pain, such as anemia and aortic stenosis. First line investigations include hemoglobin, serum lipids and resting 12 lead ECG. While a resting ECG has low sensitivity in diagnosting coronary artery disease, an abnormal ECG has been shown to identify a group at higher risk of subsequent cardiac events. Open access services extend this facility to community medical practise without in house ECG equipment.
While this arrangement facilitates this important investigation in patients with stable angina or other cardiac conditions, patients with unstable chest pain or chest pain at rest should continue to be refers to acute secondary care facilities, as time is of the essence in the prompt identification and management of these conditions.
Current guidelines on stable angina from the British Cardiac Society and the Royal College of Physicians recommended that all newly diagnosed patients with stable angina should be refereed for an objective assessment of myocardial ischaemia. Exercise stress testing with standardized treadmill or bicycle protocols may both confirm the diagnosis and indicate prognosis in angina. Exercise induced ST segment shift has 84% specificity and 68% sensitivity for the diagnosis of angina. False positive investigation occur particularly in young women.
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