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

• Published in: Circulation (New York, N.Y.) Vol. 144; no. 22; pp. e368 - e454
• Main 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.
• Format: Journal Article
• Language: English
• Published: United States Lippincott Williams & Wilkins 30.11.2021
• Subjects: Algorithms; American Heart Association; Chest Pain - diagnosis; Chest Pain - physiopathology; Chest Pain - therapy; Humans; Observational Studies as Topic; Randomized Controlled Trials as Topic; Registries; United States; United States; coronary artery disease; angina; biomarkers; cardiac imaging; myocardial infarction; accelerated diagnostic pathway; noncardiac; AHA Scientific Statements; chest pain syndromes; acute coronary syndrome; myocardial injury; noncardiac chest pain; chest pain; shared decision-making; myocardial ischemia; troponins; clinical decision pathway; sex differences
• ISSN: 0009-7322; 1524-4539; 1524-4539
• DOI: 10.1161/CIR.0000000000001029

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. 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.