Do the NICE guidelines for chest pain add up?
Dear Sirs,
The recent articles by Purvis and Hughes1 and Kelly et al.2 question the issued guidance from the National Institute of Health and Clinical Excellence (NICE) on the investigation of patients with recent onset chest pain.3 Purvis and Hughes focused on the investigation of patients in the low risk category for coronary artery disease (CAD), who under the NICE guidelines would be referred directly for computed tomography (CT) calcium scores (CTC) rather than exercise tolerance tests (ETTs), as is current practice in many hospitals. Their results were inconclusive, indicating that there may