Table 2

Diagnosis of 2023 patients who contacted the OHS-PC for chest discomfort (pain, pressure, tightness or discomfort), divided into NTS high urgency (U1–U2) and low urgency (U3–U5)

DiagnosisNTS high urgency
n=1208 (59.7%)
NTS low urgency
n=815 (40.3%)
P value
ACS171 (14.2)56 (5.6)<0.001
 STEMI51 (29.8)16 (28.6)0.858
 NSTEMI71 (41.5)22 (39.3)0.768
 UAP38 (22.2)14 (25.0)0.668
 Non-classified ACS11 (6.4)4 (7.1)0.853
Other life threatening events (LTEs)38 (3.1)20 (2.5)0.361
 Pulmonary embolism6 (15.8)7 (35.0)0.095
 Acute abdominal aneurysm5 (13.2)0 (0.0)0.151
 Thoracic aortic dissection3 (7.9)2 (10.0)0.786
 Other*24 (63.2)11 (55.0)0.546
Non-urgent cardiovascular diseases†257 (21.3)121 (14.8)<0.001
Non-cardiac chest pain, not further specified ‡180 (14.9)169 (20.7)0.001
Musculoskeletal pain173 (14.3)189 (23.2)<0.001
Psychogenic disorders116 (9.6)110 (13.5)0.006
Gastrointestinal tract disorders97 (8.0)46 (5.6)0.04
Respiratory tract disorders66 (5.5)45 (5.5)0.955
Other non-urgent diagnoses§110 (9.1)59 (7.2)0.137
  • *Stroke, severe COPD exacerbation, acute severe heart failure, sepsis, coronary spasm caused by hypokalaemia, diabetic ketoacidosis, epileptic insult, bleeding from oesophageal varices, ovarian torsion, ventricular fibrillation.

  • †Stable angina pectoris (including atypical chest pain), stable heart failure, arrhythmias, hypertension.

  • ‡Cardiac pathology unlikely after cardiologist’s or GP’s diagnostic work-up, but without differential diagnosis.

  • §Among others: anaemia, carcinoma, vasovagal collapse, side effects to medication, dermatologic diseases.

  • ACS, acute coronary syndrome ; NSTEMI, non-ST elevation myocardial infarction; NTS, Netherlands Triage System; OHS-PC, out-of-hours services for primary care; STEMI, ST elevation myocardial infarction; UAP, unstable angina pectoris.