Management of Suspected Acute Coronary Syndrome (ACS)

This guideline has been updated in the interim to include the new GGC Chest Pain Pathway. The guideline will be updated with further clinical information in due course. 


Chest pain is one of the most common presentations at A&E. There is a long list of differential diagnoses.

Assessment / monitoring

Record ECG (continuous monitoring), take a good history, measure blood pressure and perform all general assessment measures for an acute admission. Test for troponin if acute coronary syndrome is suspected with a suggestive history (even if no ECG changes) but particularly if there are ECG changes, risk factors for, or known, coronary disease, or there is another good clinical reason for testing. Troponin testing should not be used as a catch-all test in a 'routine' battery.

The GGC Chest Pain Pathway should be followed once ACS is established as the most likely cause of the presenting complaint.


Guideline reviewed: December 2023

Page updated: December 2023