A study analysing the new rapid access chest pain clinic at Mater Dei Hospital, Malta

Abstract

BACKGROUND: This study is a service evaluation of the new rapid access chest pain clinic (RACPC), introduced in January 2021 at Mater Dei Hospital, Malta.

OBJECTIVE: To determine whether the current practices meet the needs of the local population for diagnosis and management of coronary artery disease.

METHOD: A quantitative methodology using a service evaluation design frame was used. Retrospective descriptive analysis was used to analyse the data.

RESULTS: Results showed that 55.95% of patients were seen in less than fourteen days from time of referral. Fifty-four point six five per cent of patients were classified as having cardiac pain at the end of the initial clinical review. Seventy-six point four seven per cent of exercise stress tests and 92.75% of echocardiograms were performed on the day. Thirteen point seven nine per cent of patients were referred directly for a coronary angiogram having a positive predictive value of 75%.

CONCLUSION: The RACPC in Malta is effective in identifying coronary artery disease as compared to clinics in the United Kingdom (UK). A more refined referral system is needed for patients to be more adequately triaged. More clinics and further resources are needed to keep within the recommended timeframe for patient review. Subsequent work may assess future outcomes of this patient cohort and further identify the unknown sources of referral to evaluate potential problems in the referral system.