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

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.