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Tier 4 — Narrative / commentaryGuideline

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

Martha Gulati, Phillip D. Levy, Debabrata Mukherjee, Ezra A. Amsterdam, Deepak L. Bhatt, Kim K. Birtcher, Ron Blankstein, Jack Boyd, Renée P. Bullock-Palmer, Theresa Conejo, Deborah B. Diercks, Federico Gentile, John P. Greenwood, Erik P. Hess, Steven M. Hollenberg, Wael A. Jaber, Hani Jneid, José A. Joglar, David A. Morrow, Robert E. O’Connor, Michael A. Ross, Leslee J. Shaw

Journal of the American College of Cardiology · 2021

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Summary

A 2021 multisociety clinical guideline from the American Heart Association, American College of Cardiology, and collaborating medical organisations that synthesises contemporary literature to provide evidence-informed recommendations for chest pain evaluation and diagnosis. The guideline addresses risk stratification, appropriate diagnostic testing, and management strategies across varied clinical settings, aiming to standardise diagnostic approaches in clinical practice. As a consensus document, it does not report original research outcomes but rather collates and interprets existing evidence to guide clinician decision-making.

Regional applicability

This United States–based guideline from major American cardiology and emergency medicine organisations reflects US clinical practice standards and healthcare systems. Its recommendations may require contextualisation for United Kingdom practice, where diagnostic pathways, risk stratification tools, and access to imaging technologies differ; however, the underlying evidence synthesis and general principles of risk-based evaluation are likely transferable to inform UK guidance development.

Key measures

Recommendations for diagnostic algorithms, risk stratification protocols, and appropriate use of imaging and biomarker testing in chest pain evaluation

Outcomes reported

This guideline synthesises contemporary evidence to provide standardised recommendations for chest pain risk stratification, diagnostic testing, and management across varied clinical settings. It does not report original research outcomes but collates existing evidence to guide clinical decision-making.

Theme
Policy, governance & rights
Subject
Out of scope / non-food
Study type
Guideline
Study design
Guideline
Source type
Guideline
Status
Published
Geography
United States
System type
Human clinical
DOI
10.1016/j.jacc.2021.07.053
Catalogue ID
SNmp6e6mkb-zjooy3

Topic tags

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