Chest pain center
The Chest Pain Center adopts a multidisciplinary team approach for management. Based on rapid and accurate diagnosis, risk assessment and appropriate treatment methods, it provides effective early diagnosis and treatment for chest pain patients. Especially for high-risk chest pain such as acute myocardial infarction, pulmonary embolism, aortic dissection, tension pneumothorax, etc., timely and effective treatment can be given to avoid serious adverse consequences and to reduce the risk of acute myocardial infarction. The Chest Pain Center can also reduce misdiagnosis, missed diagnosis and over-treatment, and to improve the clinical prognosis of patients.
Requirements for Chest Pain Center of Emergency Department:
① The director of the Emergency Department is willing to undertake the task of constructing a Chest Pain Center.
② Functional facilities of Chest Pain Center were set up, including reception for patient triage, acute chest pain examination room, resuscitation room, acute chest pain observation room and other areas.
③ A standardized flow chart for triage, diagnosis and treatment of patients with acute chest pain or acute coronary syndrome has been established and implemented.
④ The first ECG of patients with acute chest pain is completed within 10 minutes after the first medical examination.
⑤ The bedside rapid detection of cardiac troponin I, N-terminal pro-brain natriuretic peptide and D-dimer project was carried out.Test report is ready in 20 minutes from the time of sampling.
WESAIL Chest Pain Center Solution
1. High-sensitivity cardiac troponin I (hs-cTnI)
Elevated cardiac troponin I (cTnI) concentration has a very high sensitivity and specificity for the diagnosis of myocardial injury/necrosis. The change of cTnI concentration is directly related to the severity, treatment decision and prognosis of AC (Acute Coronary Syndrome). cTnI is currently recognized as the “gold standard” for myocardial infarction diagnosis. With high-sensitivity cardiac troponin I (hs-cTnI), the detection sensitivity can reach the level of pg/mL, and the detection rate of normal population is >50%. The high sensitivity of hs-cTnI has a strong ability to determine minor myocardial damage. Dynamic monitoring of hs-cTnI levels can identify minor myocardial injury patients without ST-segment elevation and no typical clinical symptoms, and can accurately exclude acute myocardial infarction (AMI). hs-cTnI is therefore considered the most important parameter for Chest Pain Centers.
2. N-terminal brain natriuretic peptide (NT-proBNP)
NT-proBNP is a biomarker that can reflect cardiac function. Compared to brain natriuretic peptide (BNP), NT-proBNP has a longer biological half-life in the human body (about 12h, whereas BNP is about 20min) and the blood concentration is relatively higher (about 1520 times higher than BNP). In addition, NT-proBNP has no biological activity and will not be affected by recombinant BNP drugs. NT-proBNP is therefore considered as a better biomarker that can reflect cardiac function and can be used to diagnose symptomatic heart failure patients, evaluate the prognosis of patients with heart failure and acute coronary syndromes, and guide heart failure treatment.
D-Dimer is derived from cross-linked fibrin clots dissolved by plasmin and is closely related to myocardial infarction. As long as there is activated thrombosis and fibrinolytic activity in the blood vessels of the body, the concentration of D-Dimer will increase. Elevated D-Dimer indicates a higher risk of myocardial infarction in the future, but it is not an independent predictor. In addition to the above parameters, the other assisting diagnostic reagents include Myoglobin, CK-MB, H-FABP, MPO, Lp-PLA2, ST2, cTnI/CK-MB/Myo, PCT, hs-CRP+CRP, etc. The test results can be obtained in 2~8 minutes, and all reagents are compatible with serum, plasma and whole blood samples, providing a comprehensive diagnostic solution for Chest Pain Centers.