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Cardiology

Evaluation and Diagnosis of Chest Pain

Educational Objective
To identify the key insights or developments described in this article

1 Credit CME

JAMA

Published Online: July 1, 2022

JAMA Clinical Guidelines Synopsis

Article Information and Disclosures

David G. Beiser, MD, MS¹;

Adam S. Cifu, MD¹;

Jonathan Paul, MD¹

Author Affiliations

¹University of Chicago, Chicago, Illinois

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Chest pain is a common problem in the emergency department (ED), yet only 5.1% of patients presenting with chest pain are diagnosed with an acute coronary syndrome (ACS).¹ Given the high frequency of chest pain in the ED, the high risk associated with ACSs, and the high prevalence of coronary heart disease, the evaluation of acute chest pain is associated with significant clinical uncertainty, unnecessary testing, resource use, and cost implications. The complete guideline addresses both acute and stable chest pain; this synopsis focuses on the major recommendations for diagnosing acute chest pain.

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Article Information

Corresponding Author: Adam S. Cifu, MD, University of Chicago, 5841 S Maryland Ave, MC 3051, Chicago, IL 60637 (adamcifu@uchicago.edu).

Published Online: July 1, 2022. doi:10.1001/jama.2022.10362

Conflict of Interest Disclosures: Dr Paul reported receipt of grants from Boston Scientific and Inari Medical. No other disclosures were reported.

References

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Mahler SA , Lenoir KM , Wells BJ , et al. Safely identifying emergency department patients with acute chest pain for early discharge. Circulation. 2018;138(22):2456-2468. doi:10.1161/CIRCULATIONAHA.118.036528 PubMed Google Scholar Crossref

Amsterdam EA , Wenger NK , Brindis RG , et al. 2014 AHA/ACC guideline for the management of patients with non-st-elevation acute coronary syndromes J Am Coll Cardiol. 2014;64(24):e139-e228. doi:10.1016/j.jacc.2014.09.017 PubMed Google Scholar Crossref

AMA CME Accreditation Information

Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00  AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

1.00 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program;;
1.00 Self-Assessment points in the American Board of Otolaryngology – Head and Neck Surgery’s (ABOHNS) Continuing Certification program;
1.00 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program;
1.00 Lifelong Learning points in the American Board of Pathology’s (ABPath) Continuing Certification program; and
1.00 credit toward the CME of the American Board of Surgery’s Continuous Certification program

It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.