Chest pain is a common reason for patients to present to either general practice or hospital. It is the presenting symptom of a number of disorders, including potentially life-threatening conditions such as acute coronary syndrome, pulmonary embolus and aortic dissection. The initial evaluation of patients with chest pain is not straightforward, and failure to diagnose and treat patients with chest pain appropriately and expeditiously can have serious consequences. Included in those consequences are potential medicolegal liabilities. In this article we review the management of common causes of acute chest pain, with special emphasis placed upon the management of life-threatening causes of chest pain. We also highlight potential medicolegal pitfalls in the management of patients presenting with chest pain, and make suggestions to help avoid these pitfalls in everyday practice.
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