Introduction
Coronary artery disease (CAD) is a significant cause of morbidity and mortality in the UK, and anginal chest pain is the most common manifestation.1,2 Chest pain, however, is one of the most common presenting symptoms in both emergency, primary and secondary care, and can be secondary to a myriad of pathologies. Therefore, the diagnosis of CAD from symptoms alone can prove challenging.
Despite developments in both invasive and non-invasive CAD imaging, these investigations are not without risks and cost to the health service. Reduction of unnecessary investigations, while identifying patients most at risk, has been a major motiv
