NICE guidelines for the management of patients with stable chest pain

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]; Priyamvada Singh, M.B.B.S. [3]

Overview

The American College of Cardiology, American Heart Association, and National Institute for Health and Clinical Excellence (NICE) guidelines recommends performance of ECG for all patients with cardiac chest pain. Additionally, chest x-rays in patients with suspected congestive heart failure, aortic dissection, aortic aneurysm, valvular heart disease, pericardial disease. However, the guidelines recommend exercise testing in low and intermediate risk patients only after they have been screened for high risk features and other indications for hospital admission.

NICE guidelines for the management of patients with stable chest pain (DO NOT EDIT)

“

Clinical Assessment Take a detailed clinical history documenting: The age and sex of the person The characteristics of the pain, including its location, radiation, severity, duration and frequency, and factors that provoke and relieve the pain Any associated symptoms, such as breathlessness Any history of angina, MI, coronary revascularization, or other cardiovascular disease and Any cardiovascular risk factors Carry out a physical examination to: Identify risk factors for cardiovascular disease Identify signs of other cardiovascular disease Identify non-coronary causes of angina (for example, severe aortic stenosis, cardiomyopathy) and Exclude other causes of chest pain

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