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NICE recommendations on chest pain

Delays in getting ECG test results should be tackled to reduce heart attack deaths, it is claimed.

The National Institute for Health and Clinical Excellence (NICE) has published guidelines for doctors on diagnosing the causes of chest pain.

Swift 12-lead ECG tests should be done on patients with acute chest pain who are suspected of suffering from certain types of heart attack or angina, it says, and the wait for results should not delay a patient getting to hospital.

In addition, medics should no longer routinely administer oxygen because it could be harmful to people experiencing such heart problems, and are advised instead to monitor levels of oxygen in the blood.

Intermittent, stable chest pain should be diagnosed through clinical assessment and, if necessary, testing, NICE said.

Depending on a patient's history and heart risk factors, other causes, such as indigestion or muscular pain, should be ruled out first.

Separate guidance covering treatment of people who suffer a certain type of heart attack known as a non-ST elevation myocardial infarction (NSTEMI), or unstable angina, advises doctors to formally assess their risk of future problems using a scoring system.

Treatment should then be tailored according to the level of risk, NICE said.

The recommendations suggest other tests should also be offered, including putting dye into the arteries to show up narrowed areas (coronary angiography) and exercising or scanning with sound waves (echocardiography) or magnetic resonance imaging.

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