Acute chest pain in the emergency department

Chest pain is a symptom that can take on various semiological aspects, but there is no parallelism between its intensity and the severity of the causative condition.Diagnosis of acute chest pain calls for a well-structured, logical approach based on the patient’s history, physical examination and the usual complementary tests, including electrocardiogram and chest X-ray, which can be carried out at the patient’s bedside.The fear of acute chest pain is twofold: - Not to miss a vital distress: hemodynamic, respiratory, neurological; in which case, initial and rapid treatment must be implemented.- Eliminate life-threatening conditions such as acute coronary syndrome (ACS), aortic dissection (AD), pulmonary embolism (PE), acute pericarditis and tamponade, and compressive pneumothorax (CP).Once these serious conditions have been ruled out, other etiologies should be investigated as a second step, and the patient relieved and referred to a specialist consultation if necessary.