Abstract

The clinical presentation of coronary arteriosclerotic disease covers a broad spectrum: from the patient totally asymptomatic, despite the existence of obstructive lesions of variable degree in the coronary tree, or the patient who refers precordial oppression related exclusively to physical activity, even the patient who suffers severe oppressive precordial pain at rest, and goes to the emergency room. In each of these contexts, there is a distinct physiopathological sequence, despite its common origin.

A practical proposal for the management of patients with chest pain in the emergency room, in different clinical contexts with a different pathophysiology is presented. The usefulness and interpretation of the dosage of the “cardiac enzymes” is discussed.

Keywords: chest pain; coronary thrombosis; cardiac enzymes