Chest Pain Center

Columbia's innovative Chest Pain Center is a multidisciplinary collaboration between our Division of Cardiology and the Emergency Department. Patients arriving at the Emergency Department with chest pain are rapidly triaged into one of four levels based on the urgency of their condition. Most patients with chest pain and acute coronary syndrome are evaluated by members of the Cardiology Division Nurse Practitioner Service, who then continue to provide expert care to these patients throughout their hospitalization, including their inpatient experience on 5 Garden South.

  • Level I: These are the most serious patients, those with acute myocardial infarctions (heart attacks) with ST-segment elevation. These are severe, acute heart attacks in which a coronary artery is blocked completely. These patients are immediately sent to the cardiac catheterization laboratory for primary angioplasty.
  • Level II: This category includes patients with unstable angina or myocardial infarctions without ST-segment elevation. They are immediately admitted to the Heart Institute and prepared for cardiac catheterization within 24 to 48 hours.
  • Level III: The substantial number of patients who fall into this category present with chest pain that physicians suspect is cardiac in nature, and are usually admitted to the Heart Institute to rule out a heart attack. They are followed closely by attending physicians and nurse practitioners from the Division of Cardiology, and fast-tracked for further evaluation, including stress testing.
  • Level IV: An alternative (non-cardiac) explanation for chest pain has been established.

In 2003, the program became the first chest pain center in the tri-state area to receive accreditation from the Society of Chest Pain Centers and Providers. In 2006, the program was also designated by the Society as an accredited chest pain center with PCI (percutaneous coronary intervention) designation--again, the first such center in the tri-state area.

Other awards the Chest Pain Center has received include:

  • The Voluntary Hospital Association of America's Leadership award for clinical excellence
  • The American Association of Critical Care Nurses' multidisciplinary award
Selected by the Healthcare Association of New York State's "IHI 100K Lives Campaign 2006" to improve health care throughout the state, to demonstrate top quality care for acute MI in a teaching video distributed to all hospitals in the state


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