2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR Guideline for the Evaluation and Diagnosis of Chest Pain: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Issue 22 (28th October 2021)

• Record Type: Journal Article
• Authors: Gulati, Martha; Levy, Phillip D.; Mukherjee, Debabrata; Amsterdam, Ezra; Bhatt, Deepak L.; Birtcher, Kim K.; Blankstein, Ron; Boyd, Jack; Bullock-Palmer, Renee P.; Conejo, Theresa; Diercks, Deborah B.; Gentile, Federico; Greenwood, John P.; Hess, Erik P.; Hollenberg, Steven M.; Jaber, Wael A.; Jneid, Hani; Joglar, José A.; Morrow, David A.; O'Connor, Robert E.; Ross, Michael A.; Shaw, Leslee J.
• Is Part Of: Circulation. Volume 144:Issue 22(2021)
• Page Start: e368
• Page End: e454
• Publication Date: 2021-10-28
• Subjects: AHA Scientific Statements -- chest pain -- angina -- coronary artery disease -- acute coronary syndrome -- myocardial ischemia -- myocardial infarction -- myocardial injury -- noncardiac -- accelerated diagnostic pathway -- clinical decision pathway -- sex differences -- troponins -- chest pain syndromes -- biomarkers -- shared decision-making -- noncardiac chest pain -- cardiac imaging; Blood -- Circulation -- Periodicals; Cardiovascular system -- Periodicals; Cardiology -- Periodicals; Heart -- Diseases -- Periodicals; Blood Circulation; Cardiovascular System; Vascular Diseases; 616.1
• DOI: 10.1161/CIR.0000000000001029
• Languages: English
• ISSNs: 0009-7322

Abstract

Abstract : Aim: This clinical practice guideline for the evaluation and diagnosis of chest pain provides recommendations and algorithms for clinicians to assess and diagnose chest pain in adult patients. Methods: A comprehensive literature search was conducted from November 11, 2017, to May 1, 2020, encompassing randomized and nonrandomized trials, observational studies, registries, reviews, and other evidence conducted on human subjects that were published in English from PubMed, EMBASE, the Cochrane Collaboration, Agency for Healthcare Research and Quality reports, and other relevant databases. Additional relevant studies, published through April 2021, were also considered. Structure: Chest pain is a frequent cause for emergency department visits in the United States. The "2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR Guideline for the Evaluation and Diagnosis of Chest Pain" provides recommendations based on contemporary evidence on the assessment and evaluation of chest pain. This guideline presents an evidence-based approach to risk stratification and the diagnostic workup for the evaluation of chest pain. Cost-value considerations in diagnostic testing have been incorporated, and shared decision-making with patients is recommended.