Patterns of acute chest pain at two tertiary centres in Accra, Ghana.

Alfred Doku, Tom A Ndanu, Frank Edwin, Kow Entsua-Mensah, John Tetteh, Aba Ghansah, Bernard Yeboah-Asiamah, Desrie Gyan, Innocent Adzamli, Mohammed A Sheriff, Mark Tettey
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Abstract

Objective: To assess the clinical presentation and evaluation of acute life-threatening chest pain in Accra, Ghana.

Design: This was a cross-sectional study at the emergency departments of two leading tertiary hospitals in Accra.

Settings: The study was conducted at the Korle-Bu Teaching Hospital and the 37 Military Hospital in Accra.

Participants: The study participants comprised adult patients aged 18 years and above who presented with acute chest pain at the emergency departments between April and June 2018.

Main outcome: Acute coronary syndrome is the leading life-threatening cause of chest pain with poor pre- and in-hospital care.

Results: 232 patients with chest pain were enrolled as respondents aged 18 to 94 years. The prevalence of life-threatening conditions causing chest pain was 31.9% of those who presented with acute chest pain. These included acute coronary syndrome (82.4%), pulmonary embolism (14.9%), and acute chest syndrome (2.7%). A few (6.6%) with life-threatening conditions such as acute coronary syndrome were transported by ambulances, and 44.3% reported to the facility within 2 to 9 days after the onset of chest pain. None of the patients with pulmonary embolism and acute chest syndrome had computer tomography pulmonary angiogram (CTPA) and echocardiogram done, respectively.

Conclusion: Our study found that life-threatening conditions amongst patients presenting with acute chest pains are common; however, there is a need to improve pre-hospital care and in-hospital assessment of these cases.

Funding: The study was partly funded by the Medtronic Foundation.

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加纳阿克拉两家三级医疗中心的急性胸痛模式。
目的:评估加纳阿克拉危及生命的急性胸痛的临床表现和评估:评估加纳阿克拉危及生命的急性胸痛的临床表现和评估:设计:这是在阿克拉两家主要三级医院急诊科进行的一项横断面研究:研究在阿克拉的科勒布教学医院和第 37 军事医院进行:研究参与者包括2018年4月至6月期间在急诊科就诊的18岁及以上急性胸痛成年患者:急性冠状动脉综合征是危及生命的主要胸痛原因,院前和院内治疗效果不佳.结果:232 名胸痛患者作为受访者入选,年龄在 18 至 94 岁之间。在急性胸痛患者中,有 31.9% 的人因危及生命的疾病而导致胸痛。其中包括急性冠状动脉综合征(82.4%)、肺栓塞(14.9%)和急性胸部综合征(2.7%)。少数(6.6%)急性冠状动脉综合征等危及生命的患者被救护车送往医院,44.3%的患者在胸痛发生后 2 到 9 天内到医院报到。肺栓塞和急性胸部综合征患者均未分别进行计算机断层扫描肺血管造影(CTPA)和超声心动图检查:我们的研究发现,在急性胸痛患者中,危及生命的情况很常见;但是,有必要改善对这些病例的院前护理和院内评估:本研究得到了美敦力基金会的部分资助。
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