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NICE guidelines 2010 

''Acute chest pain''
''Immediate management of suspected ACS''  
glyceryl trinitrate
aspirin 300mg (nil else outside hospital)
O2 if  sats < 94% (or 88% if COPD)
ECG if possible but do not delay transfer (normal ECG does not exclude ACS)
''Referral''
current chest pain or chest pain in the last 12 hours with an abnormal ECG: emergency admission
chest pain 12-72 hours ago: refer to hospital the same-day for assessment
chest pain > 72 hours ago: perform full assessment with ECG and troponin measurement before deciding upon further action

''Patients presenting with stable chest pain''
NICE - complex tables
based on Sx age gender and risk factors
''anginal pain''
1. constricting discomfort in the front of the chest, neck, shoulders, jaw or arms
2. precipitated by physical exertion
3. relieved by rest or GTN in about 5 minutes
patients with all 3 features have typical angina
patients with 2 of the above features have atypical angina
patients with 1 or none of the above features have non-anginal chest pain

If typical angina and risk of CAD is > 90% -  no further diagnostic testing is required. 
all men over 70y who have typical anginal symptoms fall into this category.

Else .... (note no exercise tolerance test)
|risk of CAD|Diagnostic test|
|61-90%|Coronary angiography|
|30-60%|Functional imaging - myocardial perfusion scan with SPECT, stress echocardiography, first-pass contrast-enhanced magnetic resonance (MR) perfusion, MR imaging for stress-induced wall motion abnormalities|
|10-29%|CT calcium scoring|