Place for "Chest Pain Unit" in France. Emergency physicians point of view

The concept of "Chest Pain Unit" was born in the United States in the 1980s. The interest of the transposition, in France, of this American concept is not obvious. Radical difference in cardiovascular risk factors, coronary heart disease prevalence and in emergency care organization are the first limits. The medico-economic analysis of "Chest Pain Unit" does not seem to be favorable. The only published French experience provides no convincing arguments. In consequence, in the French system, early call to the SAMU-Centre 15, prehospital medical management and direct access to the cath lab or cardiologic ICU must remain the rule. This strategy is associated with time saved and reduced morbidity and mortality. To educate the patient at vascular (cardiologic and neurologic) risk in this sense should be encouraged.