GRACE-1 Guidelines for Adult Patients with Recurrent Low-Risk Chest Pain 1) Pain > 3 hours - A single, high sensitivity troponin to reasonably exclude ACS within 30 days 2) Normal stress test within the past 12 months - Repeat stress testing to decrease 30-day MACE NOT recommended 3) For all adult patients with recurrent, low-risk chest pain - Hospitalization (neither inpatient or observation stay) NOT recommended 4) With non-obstructive (<50%) CAD on prior angiography in past 5 years - Referral for expedited outpatient testing rather than inpatient admission 5) With no occlusive CAD (0% stenosis) on prior angiography in the past 5 years - Referral for expedited outpatient testing rather than inpatient admission 6) With no coronary stenosis on CCTA within past 2 years - No further diagnostic testing other than a single high-sensitivity troponin to exclude ACS within those 2 years 7) For all adult patients with recurrent, low-risk chest pain - Depression and anxiety screening tools are recommended to evaluate healthcare use and return 8) For all adult patients with recurrent, low-risk chest pain - Referral for anxiety and depression management are recommended #ChestPain #LowRisk #GRACE #Guidelines #cardiology #management
