What are the referral criteria for a patient with chest pain who has risk factors for coronary artery disease?

Refer people to hospital as an emergency if they currently have chest pain, or if they are pain-free but had chest pain in the last 12 hours and an abnormal or unavailable resting 12‑lead ECG ¹.

Refer people for urgent same-day assessment if they had chest pain in the last 12 hours but are now pain free with a normal resting 12‑lead ECG, or if the last episode was 12 to 72 hours ago ¹.

Refer people for assessment in hospital if the pain has resolved but there are signs of complications such as pulmonary oedema, using clinical judgment to decide whether the referral should be emergency or urgent ¹.

Admit people with clinical features suggesting a serious cause of chest pain, such as respiratory distress, hypotension, hypoxia, altered consciousness, or signs of complications, including suspected ACS with current pain or recent pain with abnormal ECG ².

Consider admitting people with suspected ACS if pain has resolved but there are signs of complications, and use clinical judgment for emergency or urgent referral ².

Refer people with suspected ACS to hospital as an emergency if they currently have chest pain or had chest pain in the last 12 hours with abnormal ECG or no ECG available ².