April 20, 2026Journal of the American College of Cardiology
2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR Guideline for the Evaluation and Diagnosis of Chest Pain
Why the study?
Chest pain is a frequent cause for emergency department visits in the United States, prompting an evidence-based clinical practice guideline for clinicians to assess and diagnose chest pain in adult patients.
Key Points
- The guideline aims to provide clinicians with structured recommendations for evaluating chest pain in adults.
- Comprehensive literature search conducted from November 2017 to May 2020.
- Included randomized and nonrandomized trials, observational studies, registries, and reviews published in English.
- Incorporated additional relevant studies published through April 2021.
- Chest pain is a common reason for emergency department visits in the U.S.
- Guidelines recommend an evidence-based approach for risk stratification and diagnostic testing.
- Shared decision-making with patients is advised to enhance the care process.
Structured PICO
P
Population
Adult patients presenting with chest pain
I
Intervention
Evidence-based approach to risk stratification and diagnostic workup
Provides updated 2021 AHA/ACC multi-society clinical practice guidelines for the evaluation and diagnosis of chest pain in adults.
Authors
Discussion
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Key expert perspectives
Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
“This standard approach provides clinicians with the guidance to better evaluate patients with chest pain, identify patients who may be having a cardiac emergency and then select the right test or treatment for the right patient.”
“I hope clinicians take from our guidelines the understanding that low-risk patients often do not need additional testing. And if we communicate this effectively with our patients — meaning incorporating shared decision-making into our practice — we can reduce overtesting in low-risk patients.”
“provides a basis for standardization of care, which will help improve health outcomes and right-size resource utilization.”
Implication
Supports avoiding tests in low-risk chest pain; reinforces evidence-based stratification and shared decision-making for practice and research.
Cite This Study
Gulati et al. (2021) conducted a review in Chest pain. Clinical practice guideline for evaluation and diagnosis was evaluated. The 2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR Guideline provides evidence-based recommendations and algorithms for the risk stratification and diagnostic workup of adult patients with chest pain.