Chest pain
Cardiology · CP1
This topic appears in the RCEM clinical syllabus. Start with a relevant resource below, then use a case or practice activity to test what you have learned.
View this area in the official clinical syllabus
Choose a session for your level. The two process cards practise a focused history and a referral; LoDED is a separate higher-level appraisal exercise.
Start here
Choose a starting point to suit what you need to work on.
Chest pain: choosing the right diagnostic pathway
Start with the broad chest-pain assessment and the choice between ACS, PE and aortic pathways.
Assessing acute coronary syndrome
Then examine urgent ECG findings and the appropriate use of the local ACS pathway.
Chapter 3: History taking
Review the cardiovascular history questions before practising a consultation.
Ep 299 – Which patients with chest pain need a troponin?
Listen to the discussion of which chest-pain presentations need troponin testing.
More learning for this topic
Learn
Ep 167 – Troponin Update and LoDED Study Review with Rick Body
Use the LoDED interview alongside the higher-level chest-pain journal club.
Discuss
Recognising acute aortic dissection
Discuss when to suspect aortic dissection and how to arrange imaging and specialist care without delay.
Assessing chest pain
Use an aortic presentation and a postoperative PE concern to practise a broad differential and selective investigation.
Acute coronary syndrome: initial assessment
Connect the clinical story, ECG and assay-specific troponin pathway while recognising when treatment cannot wait.
Recognising acute aortic dissection
Use two presentations to practise recognising acute aortic syndrome and communicating the need for urgent senior assessment.
Show 1 more lessons
Journal club: LoDED and safe early discharge
Appraise the LoDED diagnostic-strategy trial and discuss what would be needed to apply its findings locally.
Practise
One learner performs. One checks the key steps and gives feedback. Then swap roles. These are practice tools, not official RCEM mark schemes.
Focused history and initial plan paired practice
Agree a chest-pain case using the cardiovascular history section, then practise the history, summary and next step. This card checks the consultation process.
Make a useful referral paired practice
Use the card’s supplied chest-pain and ST-depression case to practise a clear referral and agreement about the next action.
Teaching programmes
Starting in Emergency Medicine
1 relevant session in this programme.
Early-career Emergency Medicine
1 relevant session in this programme.
Medical Student Emergency Medicine Placement
1 relevant session in this programme.
Higher Training and Advanced Discussion
1 relevant session in this programme.
Apply it in practice
Choose one thing to try on your next suitable shift, within your role and level of supervision. Discuss what happened and what you would change.
More mapped resources
5 tagged resources