The guideline addresses the diagnosis and assessment of chest pain in adults


TUESDAY, Nov. 2, 2021 (HealthDay News) – Chest pain or discomfort can extend beyond the chest, and patients with this pain should seek immediate medical attention, according to a clinical practice guideline issued by the American Heart Association and the American College of Cardiology and published online Oct. 28 in Circulation and the Journal of the American College of Cardiology.

Martha Gulati, MD, University of Arizona at Phoenix, and colleagues conducted a comprehensive literature review to develop recommendations and algorithms for clinicians to assess and diagnose chest pain in adult patients .

The researchers note that the equivalents of angina pectoris include pain, pressure, tightness, or discomfort in the chest, shoulders, arms, neck, back, upper abdomen, or lower abdomen. jaw, as well as shortness of breath and fatigue. Patients with acute chest pain or symptoms equivalent to chest pain should seek immediate medical attention. Women are more likely to have associated symptoms of acute coronary syndrome, including nausea and shortness of breath, although chest pain is the most dominant and common symptom in both men and women. To establish a biomarker diagnosis of acute myocardial infarction, high sensitivity cardiac troponins are the preferred standard. Urgent diagnostic testing for suspected coronary artery disease is not required for patients with acute or stable chest pain considered to be at low risk. Routine use of clinical decision pathways for chest pain in the emergency department and on an outpatient basis is recommended. Cardiac imaging and tests are most beneficial for patients with acute or stable chest pain who are at intermediate risk or at intermediate to high risk for obstructive coronary artery disease. “The guideline emphasizes which tests may be most appropriate, depending on the individual situation, and which will not provide additional information,” Gulati said in a statement.

Several authors and reviewers have revealed financial ties to the pharmaceutical and medical device industries.

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