Chest pain stands out as a significant indicator for patients initially presenting with ischemic heart disease (IHD). Despite its importance, there’s limited understanding regarding the prevalence of IHD among individuals seeking consultation with general practitioners (GPs) specifically for chest pain. This study aimed to evaluate the occurrence of IHD in patients consulting GPs due to chest pain, analyze the outcomes of bicycle exercise tests conducted, and estimate the broader incidence of IHD within the population.
This prospective study was carried out across three primary healthcare centers situated in southeastern Sweden. Participants included patients aged 20 to 79, without a pre-existing IHD diagnosis, who consulted for a new episode of chest pain. Outcomes were categorized into IHD, possible IHD, or not IHD, based on postal questionnaires, exercise test results, and hospital records. Retrospective analysis was also performed on hospital registry data concerning patients diagnosed with IHD.
The study revealed that chest pain accounted for 1.5% (577 out of 38,075) of all GP consultations. Among these chest pain patients, 8% (41 individuals) were diagnosed with IHD, 83% (441 individuals) were excluded from an IHD diagnosis, and 9% (50 individuals) were classified as uncertain diagnoses. Notably, exercise tests provided diagnostic clarity in 77% of cases, frequently indicating normal results, even under stringent diagnostic criteria. Combining data from both primary care and hospital settings, the annual incidence of IHD was calculated at 6.5 diagnoses per 1000 residents within the 20 to 79 age group.
In conclusion, while chest pain is a noticeable symptom prompting GP visits, the actual incidence of new episodes leading patients to seek primary care was observed to be low. A definitive IHD diagnosis was confirmed in 8% of these patients, while an additional 9% required further investigation or clinical evaluation to ascertain their condition.
