Chest Pain

Preamble: The following objectives apply to chest pain presenting in the ambulatory care setting (i.e. not an Emergency department).

  • Conduct a rapid assessment to identify patients requiring emergency care
  • Describe the family physician’s role in the stabilization and initial management of patients identified to require emergent care.
    • Develop an approach to emergencies presenting in the family medicine office
    • Be able to assess urgency of a problem and communicate with the ER when appropriate
    • Understand what you need in the office for management of emergencies
  • Conduct a focused history (including cardiac risk factors) and a relevant physical exam
  • Develop a concise differential diagnosis for patients with chest pain including cardiac and non- cardiac causes.
  • Describe the key clinical characteristics of the following common chest pain conditions: angina, embolism, gastroesophageal reflux, costochondritis, anxiety, and pneumonia.

Core Resources

Chest Pain ER Care Clinical Card 2014

Elzinga KE, Walker I, Krejcik VH, Keegan DA. Chest Pain – ER Care. Canadian Family Medicine Clinical Card. 2011. Available at:

Chest pain top 10 diagnoses in family medicine

Ponka D, Kirlew M. Top 10 differential diagnoses in family medicine: Chest pain. Can Fam Physician. 2007;53(12):2146. doi: 53/12/2146 [pii].

Outpatient Diagnosis of Acute Chest Pain in Adults

McConaghy JR, Oza RS. Outpatient diagnosis of acute chest pain in adults. Am Fam Physician. 2013;87(3):177-182. doi: d10795 [pii].