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Chest Pain of Recent Onset: Assessment and Diagnosis of Recent Onset Chest Pain or Discomfort of Suspected Cardiac Origin [Internet]

Chest Pain of Recent Onset: Assessment and Diagnosis of Recent Onset Chest Pain or Discomfort of Suspected Cardiac Origin [Internet]

NICE Clinical Guidelines - National Clinical Guideline Centre for Acute and Chronic Conditions (UK)

Version: March 2010

People presenting with Stable Chest Pain

A universal definition for stable angina has not been agreed internationally, in contrast to that which has been developed for MI (Thygesen, K., Alpert, J. S., and White, H. D., 2007).

All Recommendations

(Numbers correspond to NICE guideline)

People Presenting with Acute Chest Pain Chapter

This section 4.1 examines the assessment of patients presenting with acute chest pain of suspected cardiac origin and is intended for patients presenting in both the primary and secondary healthcare settings. Importantly the initial assessment is aimed at identifying those patients with acute MI or ACS and in whom very early therapeutic interventions will make a substantial difference to patient outcomes. This encompasses determining risk factors for CAD, obtaining a clinical history, physical examination, resting ECG recording, and cardiac biomarker measurement. In reviewing this evidence and making recommendations the GDG emphasized the importance of early recognition of patients with acute MI or ACS, and adopted a high threshold for ruling out these diagnoses. If an acute MI or ACS has been ruled out, patients may still have chest pain of cardiac origin (for example patients with risk factors for CAD and troponin negative results), and these patients have been identified for further assessment according to the stable chest pain recommendations in Chapter section 1.3.

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