FOR APPs & PRIMARY CARE CLINICIANS
Chest pain & coronary disease — Quick reference
First steps, urgent findings, referral guidance, and handoff essentials.
First steps
Define symptom pattern and acuity, review EKG and coronary history, and assess risk factors and medications.
Recognize the urgent patient
Possible ACS, ongoing ischemic symptoms, instability, or severe new dyspnea requires emergency evaluation; do not await elective testing.
When to refer
Refer stable concerning symptoms or significant test findings to cardiology for test/treatment selection.
What to send with the referral
EKG; symptom timeline; prior PCI/CABG records; testing; antiplatelets; lipid results; kidney function.
Avoid this pitfall
Normal resting EKG or prior reassuring testing does not override a new high-risk presentation.
Reviewed October 11, 2026. This quick reference summarizes the linked guide; use the full guide for context and clinical references.