Research Article

Diagnostic Agreement between Prehospital Emergency and In-Hospital Physicians

Table 3

Differential diagnosis of chest pain, adapted from Conaghy et al.

Acute myocardial infarctionChest pain radiates to both arms7.10.67

ā€‰Third heart sound on auscultation3.20.88


Chest wall painAt least two of the following findings: localized muscle tension; stinging pain; pain reproducible by palpation; absence of cough3.00.47

Gastroesophageal reflux diseaseBurning retrosternal pain, acid regurgitation, sour or bitter taste in the mouth; one-week trial of high-dose proton pump inhibitors relieves symptoms3.10.30

Panic disorder/anxiety stateSingle question: in the past four weeks, have you had an anxiety attack (suddenly feeling fear or panic)?4.20.09

Acute thoracic aortic dissectionAcute chest or back pain and a pulse differential in the upper extremities5.3NA

Note: The higher the LR is above 1, the better it rules in disease (greater than 10 is considered good). Conversely, the lower the LR is below 1, the better it rules out disease (less than 0.1 is considered good). LR+ = positive likelihood ration; LR- = negative likelihood ratio; NA = not available. Information is from references [5] through [6].