BMJ  2005;330:E354 (14 May), doi:10.1136/bmj.330.7500.E354

BMJ USA: Letter

Letter

RAPID RESPONSE FROM BMJ.COM

Following is an edited excerpt from one of the Rapid Responses generated by this article, all of which can be read in their entirety at http://bmj.bmjjournals.com/cgi/eletters/330/7489/452#98052.—Editor

The patient population studied were hospital out-patients. It is not stated how they were selected to be seen at the hospital. In UK practice most would have been referred by their general practitioners, and therefore be a selected group with at least a suspicion of significant pathology. Large numbers of patients with isolated chest pain may have been filtered out prior to presentation at the hospitals on the grounds that they have `good evidence' of musculoskeletal chest pain as evidenced by localized pain and tenderness without other significant signs and symptoms.

If 20% of all patients in UK general practice presenting with isolated chest pain and tenderness have pulmonary embolism I suggest there may be a massive under diagnosis of this condition and that it warrants further study in a primary care setting.

Richard James, general practitioner

Falmouth Health Centre, TR11 4ED, UK

Competing interests: None declared.


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Rapid Responses:

Read all Rapid Responses

Re Chest pain and musculoskeletal pain
Fenella Lemonsky
bmj.com, 17 May 2005 [Full text]

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