Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible. Contents Overview 4 Who is it for? 4 1.1 Providing information for people with chest pain 5 1.2 People presenting with acute chest pain 6 1.3 People presenting with stable chest pain 15 Terms used in this guideline 23 Recommendations for research 24 1 Cost-effectiveness of multislice CT coronary angiography for ruling out obstructive coronary artery disease in people with troponin-negative acute coronary syndromes 24 2 Refining the use of telephone advice in people with chest pain 24 3 Establishing a national registry for people who are undergoing initial assessment for stable 4 Information about presenting and explaining tests 26 Putting this guideline into practice 27 Finding more information and committee details 31 Update information 32 This guideline partially replaces TA73. This guideline is the basis of QS21 and QS68. This guideline should be read in conjunction with NG185. Overview This guideline covers assessing and diagnosing recent chest pain in people aged 18 and over and managing symptoms while a diagnosis is being made. It aims to improve outcomes by providing advice on tests (ECG, high-sensitivity troponin tests, multislice CT angiography, functional testing) that support healthcare professionals to make a speedy and accurate diagnosis. NICE has also produced a guideline on managing acute coronary syndromes. Who is it for? Healthcare professionals Adults with chest pain of recent onset, their families and carers Recommendations People have the right to be involved in discussions and make informed decisions about their care, as described in NICE's information on making decisions about your care. 