Clinical Profile, Management Strategies, And Outcome Of Patients With Acute Chest Pain In Regional Referral Hospitals In Tanzania. Protocol For A Prospective, Multi-Centre Cohort Study

This study aims to understand how patients with acute chest pain are evaluated, treated, and cared for in emergency departments (EDs) at regional hospitals in Tanzania. Chest pain can be caused by many conditions, some of which are life-threatening, like heart attacks (acute coronary syndrome, or ACS). In Tanzania and other low-resource settings, delays in diagnosis and treatment can lead to poor outcomes. This study will document current practices, identify challenges, and link these findings to patient outcomes (e.g., survival, complications) to improve care for future patients. \- Participants: Adults (18 years or older) who come to the ED with chest pain or suspected acute coronary syndrome (heart problem) at the regional referral hospitals in Dar es Salaam, Tanzania. Three regional referral hospitals and one specialized cardiac hospital (Jakaya Kikwete Cardiac Institute) will be involved in this study. Research assistants will collect data during routine care. During the study, i. Enrollment will take place over 12 months; 317 patients with chest pain will be invited to participate. ii. Researchers will record: * How quickly patients receive initial diagnostic tests (e.g., ECG, blood tests for heart damage). * Treatments given (e.g., medications, procedures to restore blood flow to the heart). * Patient outcomes over 30 days (e.g., survival, readmission to the hospital, complications like another heart attack or stroke). iii. Follow-up: Patients will be contacted by phone 30 days after their ED visit to check their health status. This study is important because-: Chest pain is a common reason for ED visits, but in Tanzania, many patients face delays in diagnosis or lack access to lifesaving treatments. This study will identify gaps in care to help hospitals improve emergency services. Understanding the challenges in chest pain care can empower families to advocate for timely treatment for their loved ones. For Healthcare Providers: The findings will guide