NICE guidelines for the management of patients with acute chest pain: Difference between revisions
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* Initially assess people for any of the following symptoms, which may indicate an ACS: | * Initially assess people for any of the following symptoms, which may indicate an ACS: | ||
* Pain in the chest and/or other areas (for example, the arms, back or jaw) lasting longer than 15 minutes | ** Pain in the chest and/or other areas (for example, the arms, back or jaw) lasting longer than 15 minutes | ||
* Chest pain associated with nausea and vomiting, marked sweating, breathlessness, or particularly a combination of these | ** Chest pain associated with nausea and vomiting, marked sweating, breathlessness, or particularly a combination of these | ||
* Chest pain associated with haemodynamic instability | ** Chest pain associated with haemodynamic instability | ||
* New onset chest pain or abrupt deterioration in previously stable angina, with recurrent chest pain occurring frequently and with little or no exertion, and with episodes often lasting longer than 15 minutes | ** New onset chest pain or abrupt deterioration in previously stable angina, with recurrent chest pain occurring frequently and with little or no exertion, and with episodes often lasting longer than 15 minutes | ||
* Do not use people's response to glyceryl trinitrate (GTN) to make a diagnosis. | ** Do not use people's response to glyceryl trinitrate (GTN) to make a diagnosis. | ||
* Do not assess symptoms of an ACS differently in men and women. Not all people with an ACS present with central chest pain as the predominant feature. | * Do not assess symptoms of an ACS differently in men and women. Not all people with an ACS present with central chest pain as the predominant feature. | ||
* Do not assess symptoms of an ACS differently in ethnic groups. There are no major differences in symptoms of an ACS among different ethnic groups. | ** Do not assess symptoms of an ACS differently in ethnic groups. '''There are no major differences in symptoms of an ACS among different ethnic groups.''' | ||
* Refer people to hospital as an emergency if an ACS is suspected and: | * Refer people to hospital as an emergency if an ACS is suspected and: | ||
** They currently have chest pain or | ** They currently have chest pain or |
Revision as of 16:23, 9 May 2012
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]; Priyamvada Singh, M.B.B.S. [3]
Overview
The American College of Cardiology, American Heart Association,and National Institute for Health and Clinical Excellence (NICE) guidelines recommends performance of ECG for all patients with cardiac chest pain. Additionally, chest X-rays in patients with suspected congestive heart failure, aortic dissection, aortic aneurysm, valvular heart disease, pericardial disease. However, the guidelines recommend exercise testing in low and intermediate risk patients only after they have been screened for high risk features and other indications for hospital admission.
NICE guidelines for the management of patients with acute chest pain (DO NOT EDIT) [1]
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Initial Assessment and Referral to Hospital
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