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4.3.1. Evaluation of Acute Chest Pain With Suspected
Gastrointestinal Syndromes
COR LOE
Recommendation
2a C-LD 1. In patients with recurrent acute chest pain without evidence
of a cardiac or pulmonary cause, evaluation for gastrointestinal
causes is reasonable.
4.3.2. Evaluation of Acute Chest Pain With Suspected Anxiety
and Other Psychosomatic Considerations
COR LOE
Recommendation
2a B-R 1. For patients with recurrent, similar presentations for acute
chest pain with no evidence of a physiological cause on
prior diagnostic evaluation including a negative workup
for myocardial ischemia, referral to a cognitive-behavioral
therapist is reasonable.
4.3.3. Evaluation of Acute Chest Pain in Patients With Sickle
Cell Disease
COR LOE
Recommendations
1 B-NR 1. In patients with sickle cell disease who report acute chest
pain, emergency transfer by EMS to an acute care setting is
recommended.
1 C-LD 2. In patients with sickle cell disease who report acute chest pain,
ACS should be excluded.
