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 a guideline on managing acute coronary syndromes.
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.
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?
Septemeber 2019: We have found no new evidence that affects the recommendations. For more information, see the surveillance decision.
Guideline development process
This guideline was previously called chest pain of recent onset: assessment and diagnosis of recent onset chest pain or discomfort of suspected cardiac origin.
The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with them and their families and carers or guardian.
All problems (adverse events) related to a medicine or medical device used for treatment or in a procedure should be reported to the Medicines and Healthcare products Regulatory Agency using the Yellow Card Scheme.
Local commissioners and providers of healthcare have a responsibility to enable the guideline to be applied when individual professionals and people using services 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 complying with those duties.
Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.