Chest pain in the accident and emergency department: is chest radiography worthwhile?

Four per cent of patients attend the Accident and Emergency Department (A&E) present with chest pain. In this prospective study of 297 patients the value of chest radiography is assessed. Overall, 23% of chest X-rays (CXRs) had an abnormality which influenced management of the patient, rising to 40% in those patients admitted to Coronary Care. Twenty-nine per cent of CXRs were misinterpreted by Casualty Officers but resulted in the mismanagement of only six patients (3.3%). Potentially serious errors were averted by early CXR audit by a Radiologist.