Leon Savage
Journal of Paramedic Practice, Vol. 7, Iss. 8, 07 Aug 2015, pp 394 - 401

Background: In the pre-hospital environment, the treatment of acute coronary
syndrome (ACS) is at the forefront of most clinicians' priorities when symptoms
include non-traumatic chest pain. As ACS is a leading cause of preventable deaths,
less emphasis is placed on other potentially life-changing conditions that are
associated with non-traumatic chest pain.

Objectives: This article discusses the three main groups of cardiac infections
(pericarditis, myocarditis, and endocarditis). It then discusses how they can be
identified in the pre-hospital setting and how the ambulance service can contribute
to the subsequent diagnosis of patients presenting with these conditions.

Discussion: Pericarditis is a relatively common cause of non-traumatic chest pain.
It has symptoms that can be found in the pre-hospital environment such as specific
ECG changes and symptoms that can be identified during an initial consultation.
Myocarditis has a low incidence rate as well as a wide variety of symptoms that
can be associated with other common ailments. It is a very hard condition to
determine in the pre-hospital environment. Endocarditis in the intravenous drug
user population is a significant condition and has a high mortality rate.

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