2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR Guideline for the Evaluation and Diagnosis of Chest Pain

被引：258

作者：

Gulati, Martha ^{[1
]}

Levy, Phillip D. ^{[1
]}

Mukherjee, Debabrata ^{[1
]}

Amsterdam, Ezra ^{[1
]}

Birtcher, Kim K. ^{[1
,2
]}

Blankstein, Ron ^{[3
]}

Boyd, Jack

Bullock-Palmer, Renee P. ^{[1
]}

Conejo, Theresa ^{[1
,4
]}

Diercks, Deborah B. ^{[5
]}

Gentile, Federico

Greenwood, John P. ^{[6
]}

Hess, Erik P.

Hollenberg, Steven M. ^{[1
,7
]}

Jaber, Wael A. ^{[8
]}

Jneid, Hani ^{[9
]}

Joglar, Jose A. ^{[1
]}

Morrow, David A. ^{[1
]}

O'Connor, Robert E. ^{[1
]}

Ross, Michael A. ^{[1
]}

Shaw, Leslee J. ^{[1
]}

O'Gara, Patrick T.

Beckman, Joshua A.

Levine, Glenn N.

Al-Kharib, Sana M.

Armbruster, Anastasia L.

Brindis, Ralph G.

Cigarroa, Joaquin E.

Fuentes, Lisa de las

Deswal, Anita

Dixon, Dave L.

Fleisher, Lee A.

Hernandez, Adrian F.

机构：

[1] ACC AHA Representat, Washington, DC 20037 USA

[2] ACC AHA Joint Comm Clin Practice Guidelines Liai, Washington, DC USA

[3] Soc Cardiovasc Computed Tomog Representat, Arlington, VA USA

[4] Lay Patient Representat, London, England

[5] Soc Acad Emergency Med Representat, Des Plaines, IL USA

[6] Soc Cardiovasc Magnet Resonance Representat, Mt Royal, NJ USA

[7] Amer Coll Chest Phys Representat, Glenview, IL USA

[8] Amer Soc Echocardiog Representat, Durham, NC USA

[9] Task Force Performance Measures, Washington, DC USA

来源：

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY | 2021年 / 78卷 / 22期

关键词：

ACC/AHA Clinical Practice Guidelines; chest pain; angina; coronary artery disease; acute coronary syndrome; myocardial ischemia; myocardial infarction; myocardial injury; noncardiac; accelerated diagnostic pathway; clinical decision pathway; sex differences; troponins; chest pain syndromes; biomarkers; shared decision-making; noncardiac chest pain; cardiac imaging; CORONARY-ARTERY-DISEASE; ACUTE MYOCARDIAL-INFARCTION; COMPUTED-TOMOGRAPHY ANGIOGRAPHY; CARDIOVASCULAR MAGNETIC-RESONANCE; SENSITIVITY CARDIAC TROPONIN; FRACTIONAL FLOW RESERVE; AMERICAN-HEART-ASSOCIATION; EMERGENCY-DEPARTMENT PATIENTS; POSITRON-EMISSION-TOMOGRAPHY; APPROPRIATE USE CRITERIA;

D O I：

10.1016/j.jacc.2021.07.053

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

AIM This clinical practice guideline for the evaluation and diagnosis of chest pain provides recommendations and algorithms for clinicians to assess and diagnose chest pain in adult patients. METHODS A comprehensive literature search was conducted from November 11, 2017, to May 1, 2020, encompassing randomized and nonrandomized trials, observational studies, registries, reviews, and other evidence conducted on human subjects that were published in English from PubMed, EMBASE, the Cochrane Collaboration, Agency for Healthcare Research and Quality reports, and other relevant databases. Additional relevant studies, published through April 2021, were also considered. STRUCTURE Chest pain is a frequent cause for emergency department visits in the United States. The "2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR Guideline for the Evaluation and Diagnosis of Chest Pain" provides recommendations based on contemporary evidence on the assessment and evaluation of chest pain. This guideline presents an evidence-based approach to risk stratification and the diagnostic workup for the evaluation of chest pain. Cost-value considerations in diagnostic testing have been incorporated, and shared decision-making with patients is recommended.

引用

页码：E187 / E285

页数：99

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