2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR Guideline for the Evaluation and Diagnosis of Chest Pain

The ESC has no stand-alone chest-pain guideline — the topic is folded into the chronic coronary syndrome document — which makes this the reference text on both sides of the Atlantic for the diagnostic pathway itself. It retires the word 'atypical' in favour of 'cardiac, possible cardiac or non-cardiac', makes high-sensitivity troponin within a structured clinical decision pathway the preferred rule-out, and puts coronary CT angiography first-line in intermediate-risk patients without known coronary disease, with FFR-CT for intermediate stenoses. Deliberately, it also states where no testing is needed at all. The register's imaging and downstream-management trials are grouped below.

This guideline cites 6 of the 199 landmark trials in our Cardiology register.

Source

Gulati M, Levy PD, et al. Circulation. 2021;144(22):e368–e454.

DOI

10.1161/CIR.0000000000001029