This guideline covers assessing chest pain of recent onset in people aged 18 and over, and diagnosis of the conditions that cause it. It aims to improve care for adults with chest pain by ensuring they get the information they need and are able to make informed choices, and by specifying the assessments needed to make a diagnosis.

NICE has also produced guidelines on unstable angina and NSTEMI and on cardiac rehabilitation and prevention after a myocardial infarction.


This guideline includes recommendations on:

Who is it for?

  • Healthcare professionals
  • Commissioners and providers
  • Adults with chest pain and their families and carers

Is this guideline up to date?

We reviewed the evidence in August 2014 and we are updating the recommendations on assessing, investigating and diagnosing stable chest pain and assessing and diagnosing acute chest pain.

See the guideline in development page for progress on the update.

Guideline development process

How we develop NICE guidelines

Recommendation in this guideline replaces recommendation 1.1 of myocardial perfusion scintigraphy for the diagnosis and management of angina and myocardial infarction (NICE technology appraisal guidance 73).

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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