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Chest Pain Unit Ruling out a heart attack
03/29/2006
Heart disease is the No. 1 killer of Americans. So, it’s no surprise that more than 4.5 million patients annually visit emergency rooms with heart disease symptoms such as chest pain.

At Palmetto Health Richland’s Chest Pain Unit (CPU), patients who don’t require immediate admission to the hospital have the option of being observed in a unit designed especially for patients experiencing chest pain.

Opened last April at Palmetto Health Richland, the CPU is adjacent to the hospital’s Emergency Room. It has 20 observation rooms, four treatment beds, its own nursing staff, and is fully monitored.

“The CPU functions as an area where we rule out heart attack in patients with chest pain,” explains Palmetto Health Richland emergency physician Dr. Troy Privette, who serves as CPU medical director.

In July, Ted Powell of Lexington was one of those patients.

“I had been experiencing indigestion for more than a week,” he says. “It persisted and became more severe. I began feeling pain in my shoulder blades and chest, and was having difficulty breathing.”

Powell, who serves as the deputy coroner for Richland County, says he knew these symptoms “were nothing to play with” and feared he may be having a heart attack.

As it was in Powell’s case, when a patient comes to the Palmetto Health Richland Emergency Room with chest pain, an emergency medicine department physician, consulting with a cardiologist, performs an evaluation. If the patient does not require hospitalization but requires further evaluation, he or she may be transferred to the CPU for up to 23 hours of observation. The patient then is discharged and given instructions if follow-up medical care is needed.

“We rule out a heart attack using what is called a rule-out protocol,” Privette says. “Depending on the patient’s symptoms, we perform blood tests, an EKG and possibly a stress test. Once the protocol is complete, the cardiologist reads the stress test and decides if further work-up is necessary.

Powell spent that July night under observation in the CPU, where all the necessary tests were performed. By ruling out heart disease, the physicians discovered Powell was suffering from gastrointestinal reflux. Powell was discharged and now takes medication for reflux. He has experienced no further symptoms.

“Having a chest pain unit has given us a more rapid, streamlined, cost-effective way to diagnose heart attacks,” Privette says. “Through observation, we daily are able to help patients who otherwise would’ve automatically been admitted to the hospital and spent at least a night or two while a diagnosiswas determined.”

ANGINA VS. ATTACK

Your chest feels tight and heavy and you’re finding it hard to breathe. Could you be having a heart attack? Or is it just angina? Unless you’ve been diagnosed with angina and know the symptoms, it’s impossible to be sure.

Angina is the chest pain or discomfort that occurs when your heart doesn’t get as much blood and oxygen as it needs. Because the chest pain goes away as blood flow is restored, the heart muscle does not die. Angina is common, with more than 6 million Americans living with it. Although it may not cause long-term heart damage, it is a sign of heart disease.

If you or someone you’re with has chest discomfort, seek medical attention immediately.