These key learning points summarize the consensus- and evidence-based recommendations included in this edition. The sources listed here for each statement recommend that physicians perform or implement these actions directly in a clinical setting. A = consistent, good-quality patient-oriented evidence; B = inconsistent or limited-quality patient-oriented evidence; C = consensus, disease-oriented evidence, usual practice, expert opinion, or case series. For information about the Strength of Recommendation Taxonomy (SORT) evidence rating system, go to https://www.aafp.org/afp/2004/0201/p548.html.

1. For patients with stable, intermittent chest pain and no known coronary artery disease (CAD) presenting in the outpatient setting, risk stratification models are helpful to identify those at low risk for CAD for whom additional diagnostic testing can be deferred.
Evidence rating: SORT B
Source: Section One, reference 2 and 9 

2. For intermediate- or high-risk patients with stable chest pain and without known CAD, coronary computed tomography angiography (CCTA) and stress testing are effective options for diagnosis of CAD.
Evidence rating: SORT B
Source: Section One, reference 36

3. Echocardiography is recommended in patients with palpitations whose history, physical examination, or electro-cardiography (ECG) findings raise concern for structural heart disease. Echocardiography may be appropriate in patients presenting with palpitations without other signs or symptoms of cardiovascular disease.
Evidence rating: SORT C
Source: Section Two, reference 21