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2021 Chest Pain Guidelines

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Disclaimer is pocket guide attempts to define principles of practice that should produce high-quality patient care. It is applicable to specialists, primary care, and providers at all levels. is pocket guide should not be considered exclusive of other methods of care reasonably directed at obtaining the same results. e ultimate judgment concerning the propriety of any course of conduct must be made by the clinician aer consideration of each individual patient situation. Neither IGC, the medical associations, nor the authors endorse any product or service associated with the distributor of this clinical reference tool. Source Gulati M et al. 2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR Guideline for the Evaluation and Diagnosis of Chest Pain. 2021. doi:10.1016/j.jacc.2021.07.053. Copublished in Circulation 2021. doi:10.1161/CIR.0000000000001029. AHACHE08213a TEL: 407.878.7606 • FAX: 407.878.7611 Order additional copies at GuidelineCentral.com Copyright © 2021 All rights reserved GuidelineCentral.com Abbreviations ACS, acute coronary syndrome; AMI, acute myocardial infarction; CABG, coronary artery bypass gra; CAC, coronary artery calcium; CAD, coronary artery disease; CCTA, coronary computed tomographic angiography; CDP, clinical decision pathway; CMR, cardiovascular magnetic resonance; cTn, cardiac troponin; ECG, electrocardiogram; ED, emergency department; EMS, emergency medical services; FFR-CT, fractional flow reserve with computed tomography; GDMT, guideline-directed medical therapy; hs-cTn, high-sensitivity cardiac troponin; ICA, invasive coronary angiography; INOCA, ischemia and nonobstructive coronary artery disease; MACE, major adverse cardiac events; MBFR, myocardial blood flow reserve; METs, metabolic equivalents; MINOCA, myocardial infarction and nonobstructive coronary arteries; MPI, myocardial perfusion imaging ; NSTE-ACS, non–ST-segment–elevation acute coronary syndrome; PCI, percutaneous coronary intervention; PE, pulmonary embolism; PET, positron emission tomography ; SIHD, stable ischemic heart disease; SPECT, single-photon emission computed tomography; STEMI, ST-segment–elevation myocardial infarction; TEE, transesophageal echocardiography; TTE, transthoracic echocardiography; VF, ventricular fibrillation; VHD, valvular heart disease; VT, ventricular tachycardia

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