ACC/AHA/ASECHO/CHEST/SCCT Evaluation and Diagnosis of Chest Pain Guideline Summary

Design and created by Guideline Central in participation with the American College of Cardiology, American College of Chest Physicians, American Heart Association, American Society of Echocardiography, and Society of Cardiovascular Computed Tomography.

Document Overview

Document Title: Evaluation and Diagnosis of Chest Pain

Authoring Societies

American College of Cardiology

American College of Chest Physicians

American Heart Association

American Society of Echocardiography

Society of Cardiovascular Computed Tomography

Document Publication Date: Oct 27, 2021

Page Last Reviewed/Updated: May 5, 2026

Document Type: Guideline

Country of Publication: United States

Full Text Freely Available: Yes

Full Text Guideline: www.ahajournals.org/doi/10.1161/CIR.0000000000001029

Source Citation: Gulati M, Levy PD, Mukherjee D, Amsterdam E, Bhatt DL, Birtcher KK, Blankstein R, Boyd J, Bullock-Palmer RP, Conejo T, Diercks DB, Gentile F, Greenwood JP, Hess EP, Hollenberg SM, Jaber WA, Jneid H, Joglar JA, Morrow DA, O'Connor RE, Ross MA, Shaw LJ. 2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR Guideline for the Evaluation and Diagnosis of Chest Pain: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2021 Oct 28:CIR0000000000001029. doi: 10.1161/CIR.0000000000001029. Epub ahead of print. PMID: 34709879.

Supplemental Implementation Resources

Document Scope, Criteria, and Use Cases

Document Objectives: This executive summary of the 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.

Scope: Assessment and Screening, Diagnosis, Management

Keywords: chest pain

Target Patient Population: Patients with or at risk of developing cardiovascular disease.

Inclusion Criteria: Male, Female, Adult, Older Adult

Health Care Settings: Emergency Care, Home Health, Hospital, Medical Transportation

Intended Users: Nurse, Nurse Practitioner, Paramedic/EMT, Physician, Physician Assistant

Recommendation Development Processes & Methodology

Supplemental Methodology Resources: Data Supplement Methodology Supplement

Number of Source Documents: 395

Literature Search Start Date: Friday, November 10, 2017

Literature Search End Date: Thursday, April 30, 2020

Includes peer/external review process?: Yes

Includes public comment process?: No

Methodologist involvement?: Yes

Patient involvement?: Yes

Includes multi-disciplinary group?: Yes

Includes systematic review?: Yes

Grades quality of strength of evidence?: Yes

Grades quality of strength of recommendation?: Yes

Discloses funding source?: Yes

Discloses conflicts of interest?: Yes

Includes benefits/harms analysis with recommendations?: Yes