Chest pain of recent onset: assessment and diagnosis (CG95). A step change in the requirement for cardiovascular CT.

In March 2010, the National Institute for Health and Care Excellence (NICE) published guideline CG95 regarding the appropriate investigation of patients with chest pain of recent onset; this effectively dealt with outpatient pathways but not acute inpatient admissions.1 Subsequently, many published articles have examined the implications of this guideline; the commonest of which were reviews of the impact of CG95 on the management of these patients. In 2010, CG95 emphasised the importance of clinical assessment in establishing a diagnosis in those with chest pain. After risk stratification and initial assessment, patients were usually investigated with a functional test designed to reveal inducible ischaemia or alternatively an anatomical test to confirm the presence of obstructive disease when certain criteria were met. NICE guideline CG95 recommended investigation of any patient with a likelihood of coronary artery disease (CAD)