Background
About Chest PainPathway Rationale
- To ensure appropriate tests performed prior to referral to Cardiology services.
- To ensure referral letters contain essential information to allow appropriate grading.
- If patient has chest pain and can perform a treadmill, then a targeted Chest Pain Clinic appointment can be offered.
- If patient cannot perform treadmill, or if there are complex features or comorbidities then a standard Cardiology OPD appointment (consult with no treadmill on same day) is likely to be more appropriate.
A diagnosis of angina is more likely when the pain:
- Is located retrosternally or left pectoral region.
- Is associated with sweating, nausea, or dyspnoea.
- Radiates to neck, jaw, shoulders, arms, or back.
- Is related to exertion.
- Is exacerbated by cold.
- Is relieved by glyceryl trinitrate use.
- Is relieved by rest.
A diagnosis of angina is unlikely when the pain:
- Is continuous or very prolonged pain.
- Unrelated to activity.
- Has pleuritic features.
- Is associated with dizziness or paraesthesias.
- Is associated with difficulty swallowing.
- Is related to posture change.