Chest Pain Evaluation Algorithm
Note: This document provides a structured summary of the Chest Pain Evaluation Algorithm for educational and reference purposes. It is not a substitute for certified ACLS training and adherence to the latest guidelines published by the American Heart Association (AHA) or other relevant governing bodies. Always consult the most current official guidelines.
Recognize potential cardiac or other serious causes of chest discomfort.
ABCs, vital signs, focused history & physical exam, 12-lead ECG, IV access, initial labs (cardiac markers, electrolytes, CBC).
Is there ST-segment elevation (STEMI)?
Activate STEMI pathway. Go to STEMI Management Algorithm.
Repeat ECG, serial cardiac markers, consider other diagnostics (e.g., chest X-ray, CT scan).
Assess risk for ACS (e.g., HEART score, TIMI score). Consider patient history, ECG changes, age, risk factors, troponin.
High/Intermediate Risk: Admit, further testing (stress test, angiography). Low Risk: Consider discharge with follow-up or observation.
Inpatient management, cardiac monitoring, serial labs, stress testing, or cardiac catheterization.
Outpatient follow-up, patient education, consider observation unit stay with serial testing.
Manage ACS, pericarditis, PE, musculoskeletal pain, etc. Ensure appropriate outpatient follow-up and risk factor modification.
