Chest pain guideline 'will save thousands of lives'

Guidelines to improve early diagnosis of chest pain will save thousands of lives, NICE says.

NICE said the recommendations will help GPs diagnose suspected acute coronary syndrome (ACS) and decide what further diagnostic tests are appropriate for each patient if needed.

Chest pain is experienced by around 20-40% of the general population at some point during their lives, and accounts for 1% of visits to GPs.

Professor Liam Smeeth, GP and member of the Guideline Development Group, said the guideline provided clarity for clinicians whose patients present with acute or long-term chest pain.

‘It will ensure people are less likely to have a heart attack and more likely to get the care they need,' he said.

The guideline seeks to tailor diagnostic tests for patients dependent on the likelihood of ACS. This will diagnose CHD earlier and reduce unnecessary tests, said Prof Smeeth.

For patients who cannot be diagnosed or excluded by clinical assessment alone, GPs are advised to assess the likelihood of coronary artery disease and arrange further diagnostic tests according to set criteria.

Professor Adam Timmis, consultant interventional cardiologist and chair of the Guideline Development Group, said: ‘This guideline emphasises the central role of the initial clinical assessment in diagnosing cardiac causes of chest pain.'

He added: ‘The guideline will improve clinical decision making in patients with suspected angina, identifying those who might benefit from treatment to reduce risk and improve outcomes.'

The guidelines were jointly developed with the National Clinical Guidelines Centre for Acute and Chronic Conditions.

Meanwhile, NICE has also published the first national clinical guideline for treating neuropathic pain.

The guideline outline the most effective drugs for GPs to prescribe.

Writing in GP this week, guideline developer Professor Blair H Smith said: ‘The recommendations will help GPs determine the best treatments for adults with this difficult and distressing condition.'

Dr Fergus Macbeth, director of the Centre for Clinical Practice at NICE, said: ‘Our clinical guideline hopes to standardise the pharmacological care pathways for treating neuropathic pain in general and community healthcare settings.'

It has been estimated that approximately 1-2% of adults in the UK suffer from pain with neuropathic features.

Typically common painkillers such as aspirin, ibuprofen and paracetamol are ineffective at treating this, but there are other drugs available on the NHS that can help, said NICE.

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