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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
Institution:1. Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Tsu, Japan;2. Department of Cardiology, Japanese Red Cross Ise Hospital, Ise, Japan;3. Department of Cardiology, Matsusaka Central Hospital, Matsusaka, Japan;4. Department of Cardiology, Suzuka Kaisei Hospital, Suzuka, Japan;5. Department of Cardiology, Saiseikai Matsusaka General Hospital, Matsusaka, Japan;6. Department of Cardiology, Mie Prefecture General Medical Center, Yokkaichi, Japan
Abstract:AimThis 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.MethodsA 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.StructureChest 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.
Keywords:ACC/AHA Clinical Practice Guidelines  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
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