[2010] 1.1.1.7 Offer information after diagnosis as recommended in the relevant disease management guidelines: NICE guideline on acute coronary syndromes NICE guideline on stable angina NICE guideline on generalised anxiety disorder and panic disorder in adults NICE guideline on gastro-oesophageal reflux disease and dyspepsia in adults. 1.1.1.8 Explain if the chest pain is non-cardiac and refer people for further investigation if appropriate. [2010] 1.1.1.9 Provide individual advice to people about seeking medical help if they have further chest pain. [2010] 1.2 People presenting with acute chest pain This section of the guideline covers the assessment and diagnosis of people with recent acute chest pain or discomfort, suspected to be caused by an acute coronary syndrome (ACS). The term ACS covers a range of conditions including unstable angina, ST-segment- elevation myocardial infarction (STEMI) and non-ST-segment-elevation myocardial infarction (NSTEMI). The guideline addresses assessment and diagnosis irrespective of setting, because people present in different ways. For early management of these conditions, follow the NICE guideline on acute coronary syndromes. 1.2.1 Initial assessment and referral to hospital 1.2.1.1 Check immediately whether people currently have chest pain. If they are pain free, check when their last episode of pain was, particularly if they have had pain in the last 12 hours. [2010] 1.2.1.2 Determine whether the chest pain may be cardiac and therefore whether this guideline is relevant, by considering: the history of the chest pain the presence of cardiovascular risk factors history of ischaemic heart disease and any previous treatment previous investigations for chest pain. 