Usefulness of Chest Wall Tenderness as Bedside Test to Exclude Acute Coronary Syndrome in Different Demographic Groups
To determine the significance of a simple bedside clinical test (chest wall tenderness) to exclude myocardial ischemia in different demographic groups.
|Study Design:||Observational Model: Cohort
Time Perspective: Prospective
|Official Title:||Usefulness of Chest Wall Tenderness as Bedside Test to Exclude Acute Coronary Syndrome in Different Demographic Groups|
- Chest wall tenderness [ Time Frame: From first presententation to omission (6-12 hours) ] [ Designated as safety issue: No ]Chest wall tenderness in patients presenting with acute chest pain and acute coronary syndrome (ACS) (ST-elevation myocardial infarction, STEMI/Non-ST-elevation myocardial infarction, NSTEMI /unstable angina pectoris) vs. chest wall tenderness in patients presenting with chest pain and without ACS in different demographic groups (Age under vs. over 50 years; male vs. female, with vs. without CVRF).
- Pain description [ Time Frame: 6-12 hours ] [ Designated as safety issue: No ]Localization/Radiation of pain/first time/recurrent/ Patient thinks heart is the cause/ different CVRF/Illicit drugs/Medication - in combination with "reproducible/not reproducible pain" associated with ACS
|Study Start Date:||October 2012|
|Study Completion Date:||April 2014|
|Primary Completion Date:||November 2013 (Final data collection date for primary outcome measure)|
Other: Clinical examination: chest wall tenderness
When a patient is presenting with acute chest pain at the ER of the University Hospital of Zurich, the study physician in charge, who is acting simultaneously as one of four attending clinical physicians, is performing the physical examination according to routine clinical practice. The physical examination includes the testing of chest wall tenderness: Palpation of chest wall tenderness in lying 30° elevation of chest position. Flat index with standardized pressure where spontaneous maximum pain is reported (reproducible vs. not reproducible pain vs. no pain). Negative control (right side of chest mid-clavicle intercostal 6/7), reproducible vs. not reproducible pain vs. no pain. The same physician, who is blinded for the final diagnosis at the time of the physical examination, is also recording the patient history including the study interview using the standardized study questionnaire.
Please refer to this study by its ClinicalTrials.gov identifier: NCT01724996
|University Hospital Zurich, Division of Internal Medicine|
|Zurich, ZH, Switzerland, 8091|
|Principal Investigator:||Daniel Franzen, MD||University Hospital Zurich, Division of Internal Medicine|