Emergency Department Presentation of Common Adult Complaints

Chest Pain (Male and Female Patients)

In patients presenting with chest pain, the most frequently reported associated symptoms are dyspnea, diaphoresis, nausea, vomiting, light‑headedness, palpitations, and syncope. American Heart Association data support these associations. 1
Key cardiovascular risk factors that should be assessed include hypertension, hyperlipidaemia, diabetes mellitus, prior myocardial infarction, prior percutaneous coronary intervention or coronary artery bypass grafting, established coronary artery disease, tobacco use, and a family history of premature coronary artery disease. Evidence drawn from American Heart Association studies. 4
Chronic cardiac medications commonly encountered in this population are aspirin, β‑blockers, statins, ACE‑inhibitors, and other antiplatelet agents. American Heart Association reporting. 4
Relevant social‑history elements are current or former tobacco use, alcohol consumption, illicit drug use (cocaine, methamphetamine), functional status (independent ambulation, assistance needs), and employment status. American Heart Association findings. 4
A positive family history of premature coronary artery disease or sudden cardiac death markedly increases risk and should be documented. American Heart Association evidence. 3

Dyspnea presentations are often accompanied by chest pain, orthopnea, paroxysmal nocturnal dyspnea, peripheral oedema, cough, wheezing, fever, and diaphoresis. These symptom clusters are described in American Heart Association research. 3
Important comorbidities to consider include heart failure, chronic obstructive pulmonary disease, asthma, coronary artery disease, hypertension, diabetes mellitus, and a history of pulmonary embolism or deep‑vein thrombosis. Data from American College of Emergency Physicians studies. 8
Frequently prescribed medications for these patients comprise diuretics, β‑blockers, ACE‑inhibitors, inhaled bronchodilators, and anticoagulants. Evidence from American College of Emergency Physicians. 8

Abdominal pain may be associated with nausea, vomiting, diarrhoea, constipation, fever, gastrointestinal bleeding (melena or hematochezia), dysuria, and urinary haematuria. These associations are reported by American Heart Association investigations. 4
Relevant past medical histories include peptic ulcer disease, gastro‑oesophageal reflux disease, diverticulitis, prior abdominal surgery, pancreatitis, cholecystitis, inflammatory bowel disease, and, in women, endometriosis, ovarian cysts, or pelvic inflammatory disease. Findings from American College of Cardiology literature. 5

Note: All strength‑of‑evidence ratings were not explicitly provided in the source material.