Home

Cardiac Chest Pain Pathway

Within 30 Minutes:

Patient experiencing chest pain

12-Lead ECG
As soon as possible within 15 mins of hospital arrival, every 15 mins during pain and again when
pain free
(To be reviewed/reported by appropriately trained individual immediately after recording)

Observations:
<94%

 

ST ELEVATION
Two leads: >2 mm in V1-6 or >1 mm in other leads
LEFT BUNDLE BRANCH BLOCK (LBBB)
New or with a good history

Yes

Bleep Cardiac Specialist
Nurse on 832 who will
assess patient and
arrange transfer to the
Cardiac Centre if
appropriate
(If 9pm-8am call CCU red
phone on 5999)

Is patient suitable for
Primary PCI?

Yes - Follow Primary PCI Pathway

No - Further Managment based on clinical diagnosis

No

Aspirin 300mg (unless contraindicated)

Investigations:

  • Bloods: FBC, U&Es, Tnl, Clotting Studies (if on anti-coagulants)
  • For A&E patients – Troponin 1st Panel (DO NOT WAIT FOR RESULTS)
  • Chest X-Ray

Check ECG Changes and remember to document changes
and time of review

Consider non-cardiac causes of chest pain