37
4.2.4. Acute Chest Pain With Valvular Heart Disease
COR LOE
Recommendations
1 C-EO 1. In patients presenting with acute chest pain with suspected or
known history of valvular heart disease (VHD), TTE is useful
in determining the presence, severity, and cause of VHD.
1 C-EO 2. In patients presenting with acute chest pain with suspected or
known VHD in whom TTE diagnostic quality is inadequate,
TEE (with 3D imaging if available) is useful in determining
the severity and cause of VHD.
2a C-EO 3. In patients presenting with acute chest pain with known or
suspected VHD, CMR imaging is reasonable as an alternative
to TTE and/or TEE is nondiagnostic.
4.3 Evaluation of Acute Chest Pain With Suspected
Noncardiac Causes
COR LOE
Recommendation
1 C-EO 1. Patients with acute chest pain should be evaluated for
noncardiac causes if they have persistent or recurring
symptoms despite a negative stress test or anatomic cardiac
evaluation, or a low-risk designation by a CDP.
