Approach To Chest Pain


Chest pain is a common general practice presentation, which, because of its diverse and potentially serious causes, requires careful and often urgent assessment. For patients with suspected cardiac cause, one of the aims of initial assessment is to differentiate patients who require urgent hospital-based assessment for possible acute coronary syndrome (ACS) from those with more stable symptoms who may be investigated on an outpatient basis. This latter group typically require testing for underlying myocardial ischaemia.

“Significant recent advances in the clinical approach to patients with acute chest pain, including better understanding of risk stratification, increasingly sensitive cardiac biomarkers and new non-invasive tests for coronary disease, can help clinicians minimise the risk of unexpected short-term adverse cardiac events.” The choice of diagnostic testing is vast (exercise stress test, stress echocardiogram, nuclear stress test, CT coronary angiogram, invasive coronary angiogram) and each test possesses certain advantages and limitations.  As a result, one test does not fit all patients and the selection of the most appropriate test for your patient is often confusing but in practice can be simplified based on a number of patient and clinical factors.


  1. Evaluate a patient presenting with chest pain and describe appropriate initial management..
  2. Describe the investigations available for assessing cardiac causes of chest pain and their relative strengths and weaknesses
  3. Outline the basic management algorithms for stable angina versus acute coronary syndrome
  4. Implement strategies that ensure continuity of care of patients with angina or following acute coronary syndrome including robust recall systems, effective inter-disciplinary communication and utilisation of referral pathways for timely access to necessary care.
  • Presenter(s):William Wilson
    Matthew Brooks
  • Host:Melbourne Private Hospital
  • Duration:1.43.29hrs
  • Activity ID:160123
  • QI&CPD Points:3
  • Provider:Healthscope

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