[The long-term prognosis of patients with acute chest pain of various origins].

A total of 204 patients with acute chest pain, but without myocardial infarction (non-AMI) were included. In 56 a definite diagnosis was obtained within 24-48 hours of admission. The remaining 148 patients underwent a comprehensive examination program. Ischaemic heart disease (IHD) was diagnosed in 64 patients, 81 had gastro-oesophageal disorders, 58 chest wall disorders, nine pericarditis, five pulmonary embolism, four pneumonia/pleuritis, three pulmonary cancer, two dissecting aortic aneurysm, one aortic stenosis and one herpes zoster. During 33 months of follow-up, 31 of the 64 patients with IHD had a cardiac event (cardiac deaths, non-fatal AMI, bypass surgery or PTCA) whereas only three events occurred among the 140 patients without IHD (p < 0.00001). However, the frequency of readmissions and of recurrent episodes of chest pain were similar in the three major diagnostic groups (NS). It is concluded that the high risk subset of a non-AMI population can be identified by means of non-invasive cardiac examination. The remainder who have other diagnoses are at low risk. However, the morbidity is high with frequent readmissions and recurrent episodes of chest pain, and the need for development of strategies with regard to diagnosis and treatment of these patients is emphasized.