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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We have read with interest the article by Montero-P&#233;rez et al&#46; on the diagnostic validity of nonverbal language in coronary pain&#44; which concluded that certain hand gestures are not useful for understanding the ischemic etiology of a chest pain&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a> Although we agree with some of the conclusions&#44; we would like to discuss some of the issues&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Firstly&#44; the study sample should have been divided according to groups with a greater likelihood of atypical presentation&#44; such as the elderly&#44; women and patients with diabetes&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">2</span></a> Secondly&#44; it would have been appropriate to consider aspects such as the patient&#39;s cultural level&#44; previous history of other chest pain episodes &#40;of coronary origin or not&#41; and other factors that could have affected the level of information on the chest pain&#44; given that the patients might illustrate the pain with gestures that depend on their prior experience and education level&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">3</span></a> Finally&#44; if the objective was to try to associate the chest pain with the nonverbal language&#44; future studies should delve further into other signs such as the presence or absence of vegetative symptoms&#44; tachypnea and simply the patient&#39;s general impression&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">4</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Given the above and despite the results shown by Montero-P&#233;rez et al&#46;&#44; further research is needed on any clinical aspect that can contribute to improving the diagnosis of acute coronary syndrome in emergency departments&#44; so that decisions can be made quickly on the appropriate treatment and destination&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a></p></span>"
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Correspondence
DOI: 10.1016/j.rceng.2017.12.006
Continued research into nonverbal language in chest pain of coronary origin
Sigamos investigando sobre el lenguaje no verbal en el dolor torácico de origen coronario
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G. Llopis García, M.C. Yañez-Palma, S. Iglesias López, E. Rodríguez Adrada
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fleischmangirl@hotmail.com

Corresponding author.
Servicio de Urgencias, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
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