What is the most common cause of chest pain in the emergency department?

Acute coronary syndrome (ACS) is the most common cause of chest pain encountered in the emergency department. ACS encompasses a range of conditions including unstable angina and myocardial infarction, both of which can present with chest discomfort.

The prevalence of ACS in chest pain presentations is significant due to the underlying pathophysiology of coronary artery disease, which is a leading health issue in many populations. Patients often present with symptoms such as chest tightness, pressure, or pain that may radiate to other areas like the arms, neck, or jaw.

Recognizing ACS promptly is critical for appropriate management, as it can lead to severe complications like heart failure or sudden cardiac death if not addressed in a timely manner. Emergency department protocols prioritize the evaluation of chest pain for ACS due to its high incidence and potential for rapid deterioration.

While other conditions like aortic dissection, pneumothorax, and pulmonary embolism are indeed important differential diagnoses and can present with chest pain, they occur less frequently in comparison to ACS overall. Thus, it underscores the importance of ACS as the primary focus when evaluating chest pain in an emergency setting.