This guideline covers assessing and diagnosing recent chest pain in people aged 18 and over and managing symptoms while a diagnosis is being made. It aims to improve outcomes by providing advice on tests (ECG, high-sensitivity troponin tests, multislice CT angiography, functional testing) that support healthcare professionals to make a speedy and accurate diagnosis.

NICE has also produced guidelines on managing unstable angina and NSTEMI and managing myocardial infarction with ST-segment elevation.

In November 2016, we reviewed the evidence for high-sensitivity troponin tests, non-invasive imaging and exercise ECG for adults with acute chest pain, and diagnostic testing for adults with stable chest pain. We changed and added some recommendations in section 1.2 and section 1.3.

Recommendations

This guideline includes recommendations on:

  • providing information for adults with chest pain
  • assessing and managing acute chest pain
  • assessing and managing stable chest pain

Who is it for?

  • Healthcare professionals
  • Adults with chest pain of recent onset, their families and carers

Is this guideline up to date?

Next review: November 2018

Guideline development process

How we develop NICE guidelines

This guideline was previously called chest pain of recent onset: assessment and diagnosis of recent onset chest pain or discomfort of suspected cardiac origin.

Your responsibility

The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or service users. The application of the recommendations in this guideline is not mandatory and the guideline does not override the responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or their carer or guardian.

Local commissioners and/or providers have a responsibility to enable the guideline to be applied when individual health professionals and their patients or service users wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with compliance with those duties.

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