You are currently viewing Chest Discomfort Epidemiology : Mnemonics

Students of medicine and nursing can use the mnemonic “CHEST DISCOMFORT” to memorize the main ideas of chest discomfort quickly and effortlessly. When studying for a test or working in a clinical setting, students might benefit from using mnemonics to remember key concepts and facts.

Students can use this mnemonic to remember important details about the epidemiology and natural history of chest pain, such as the most common etiologies, the risk of a missed MI diagnosis, and the most frequent presentations to the emergency room. 

Millions of people every year seek emergency care in the United States for chest pain. Hospitalization is prevalent even though most individuals do not have acute coronary syndrome (ACS), and the assessment process for chest pain can be lengthy and costly.

Patients are put at greater risk of dying if their myocardial infarction (MI) is not properly diagnosed. The most prevalent diagnosis for chest pain are related to the digestive system, however there are many other reasons.

Chest Discomfort Epidemiology & Natural History :

  • C – Chest discomfort is one of the most common reasons for ED visits in the US, resulting in 6-7 million emergency visits annually.

  • H – Hospitalization is common, with more than 60% of patients with chest discomfort being admitted for further testing.

  • E – Excluded causes are common, with fewer than 15% of patients being diagnosed with acute coronary syndrome (ACS).

  • S – Severe causes are relatively rare, with only 5% of patients experiencing other life-threatening cardiopulmonary conditions.

  • T – Time and resources devoted to evaluating chest discomfort without a severe cause are significant.


  • D – Discharged patients with presumed nonischemic etiology have a disconcerting 2-6% chance of having a missed myocardial infarction (MI).

  • I – Increased risk of death in patients with missed MI diagnosis; 30-day risk is double that of their counterparts who are hospitalized.

  • S – Specific natural histories of various chest discomfort needs to be studied separately

  • C – Chest discomfort patients with unspecified presumed noncardiopulmonary chest discomfort have a mortality rate of <2% and do not differ significantly from age-adjusted mortality in the general population.

  • O – One large population-based study found a 2.5% rate of major cardiovascular events through 30 days in low-risk patients with acute chest pain who were excluded for ST-segment elevation or noncardiac chest pain.

  • M – Mortality rate for patients with unspecified presumed noncardiopulmonary chest discomfort is <2% one year after discharge.

  • F – Fewer than 15% of evaluated patients with chest discomfort are eventually diagnosed with ACS.

  • O – Other gastrointestinal causes are the most common diagnoses, with as few as 5% being other life-threatening cardiopulmonary conditions.

  • R – Resources and time devoted to evaluating chest discomfort in the absence of a severe cause are substantial.

  • T – Transient acute chest discomfort can exclude ACS or another acute cardiopulmonary cause but the cause is not determined.



Dr. Arin Nandi

Passionate About Medical Science & Helping Future Doctors Achieve Top Ranks In Medical Exams. He is professionally a dentist as well as a public health expert from JIPMER (1), (2)working in health department