Where recommendations end [2010], the evidence has not been reviewed since the original guideline. We have also made some changes without an evidence review: some 2010 recommendations have been updated to align with the 2016 recommendations some recommendations have been updated to clarify the use of high-sensitivity troponin testing some recommendations have been updated to remove reference to estimate of the likelihood of coronary artery disease reference to autopsy as a diagnostic criterion has been removed. These recommendations are marked [2010, amended 2016]. Minor changes since publication October 2022: We added text to indicate that pulse oximetry may be less reliable in people with dark skin. We also added a link to the NHS patient safety alert on the risk of harm from inappropriate placement of pulse oximeter probes. See recommendation 1.2.3.3. November 2020: We linked to the updated guideline on acute coronary syndromes. August2020: We linked to updated diagnostics guidance in recommendations on use of biochemical markers for diagnosis (section 1.2.5). January 2020: The title of the guideline was updated to clarify that it covers chest pain of suspected cardiac origin. We linked to the universal definition of myocardial infarction in recommendation 1.2.6.1 and added a cross-reference to related NICE medical technologies guidance at the end of section 1.3.4. Accreditation