- Clinical history – taking the time to take a focused clinical history is key to making a diagnosis and reducing the risk of missing the possibility of a cardiac cause which could have life-threatening consequences.
- Referral to Rapid Access Chest Pain (RACP) is vital for patients with a suspected new diagnosis of Angina or where there has been a change to previously stable symptoms (Bear in mind that if this is a sudden change and ACS is suspected, this warrants emergency admission to hospital). This allows a focused clinical history and cardiovascular assessment to take place, as well as further investigation by ETT if appropriate.
- Risk Factors – It is important to investigate the patients past medical history and risk factors for CHD so that opportunities for lifestyle change and intervention (such as stress management) can be put in place to reduce risk.
- Exercise Tolerance Test – a positive exercise tolerance test along with a history suggestive of Angina lends weight to the diagnosis however the angiogram is really the gold standard test which is required to demonstrate evidence of coronary artery narrowing.
- Action if further chest pain – whilst awaiting angiography it is important to ensure that the patient has a clear understanding of what action to take if she experiences any chest pain and in particular if this pain does not respond quickly to rest or GTN, namely that she must call 999.
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Page last reviewed: 04 Jun 2020
