High-sensitivity cardiac troponins are the preferred standard for establishing a biomarker diagnosis of acute myocardial infarction, allowing for more accurate detection and exclusion of myocardial injury.Įarly Care for Acute Symptoms. Pain, pressure, tightness, or discomfort in the chest, shoulders, arms, neck, back, upper abdomen, or jaw, as well as shortness of breath and fatigue should all be considered anginal equivalents.
Top 10 Take-Home Messages for the Evaluation and Diagnosis of Chest PainĬhest Pain Means More Than Pain in the Chest. Reviewer Relationships With Industry and Other Entities (Comprehensive) e276 Stress CMR Cost-Value Considerations e247Īuthor Relationships With Industry and Other Entities (Relevant) e273 Stress Nuclear MPI Cost-Value Considerations e246 Stress Echocardiographic Cost-Value Considerations e246 Patients With Suspected Ischemia and No Obstructive CAD (INOCA) e244Ĭost-Value Considerations in Diagnostic Testing e246 5.3.1.ĬCTA and CAC Scanning Cost-Value Considerations e246Įxercise Electrocardiographic Cost-Value Considerations e246 Patients With Known Nonobstructive CAD Presenting With Stable Chest Pain e243 Patients With Prior CABG Surgery With Stable Chest Pain e242 Patients With Obstructive CAD Who Present With Stable Chest Pain e239 5.2.1.1. Patients With Known CAD Presenting With Stable Chest Pain e239 5.2.1. Intermediate-High Risk Patients With Stable Chest Pain and No Known CAD e235 Low-Risk Patients With Stable Chest Pain and No Known CAD e233 Pretest Risk Probability to Guide Need for Stress and Anatomic Tests e233 Patients With No Known CAD Presenting With Stable Chest Pain e232 5.1.1. Shared Decision-Making in Patients With Acute Chest Pain e225Įvaluation of Acute Chest Pain With Nonischemic Cardiac Pathologies e226 4.2.1.Īcute Chest Pain With Suspected Acute Aortic Syndrome e226Īcute Chest Pain With Suspected Myopericarditis e227Īcute Chest Pain With Valvular Heart Disease (VHD) e228Įvaluation of Acute Chest Pain With Suspected Noncardiac Causes e229 4.3.1.Įvaluation of Acute Chest Pain With Suspected Gastrointestinal Syndromes e231Įvaluation of Acute Chest Pain With Suspected Anxiety and Other Psychosomatic Considerations e231Įvaluation of Acute Chest Pain in Patients With Sickle Cell Disease e232Įvaluation of Patients With Stable Chest Pain e232 5.1. High-Risk Patients With Acute Chest Pain e222Īcute Chest Pain in Patients With Prior Coronary Artery Bypass Graft (CABG) Surgery e223Įvaluation of Patients With Acute Chest Pain Receiving Dialysis e224Įvaluation of Acute Chest Pain in Patients With Cocaine and Methamphetamine Use e224 Intermediate-Risk Patients With Acute Chest Pain and Known CAD e220 Intermediate-Risk Patients With Acute Chest Pain and No Known CAD e217 4.1.2.1.1. Intermediate-Risk Patients With Acute Chest Pain e217 4.1.2.1. Low-Risk Patients With Acute Chest Pain e215 4.1.1.1.Ĭost-Value Considerations in the Evaluation of Low-Risk Patients e216 Patients With Acute Chest Pain and Suspected ACS (Not Including STEMI) e212 4.1.1. Stress Nuclear (PET or SPECT) Myocardial Perfusion Imaging e209Ĭardiovascular Magnetic Resonance Imaging e209Ĭardiac Testing Considerations for Women Who Are Pregnant, Postpartum, or of Child-Bearing Age e210Ĭhoosing the Right Pathway With Patient-Centric Algorithms for Acute Chest Pain e210 4.1. Organization of the Writing Committee e192Ī Focus on the Uniqueness of Chest Pain in Women e198Ĭonsiderations for Older Patients With Chest Pain e199Ĭonsiderations for Diverse Patient Populations With Chest Pain e200Ĭardiac Testing General Considerations e206 3.1.Ĭoronary Computed Tomography Angiography e207Įchocardiography/Stress Echocardiography e208 Top 10 Take-Home Messages for the Evaluation and Diagnosis of Chest Pain e190 #Former ACC/AHA Joint Committee member current member during the writing effort. Levine, MD, FACC, FAHA, Immediate Past Chair #