orIgInAl ArtIclePurpose. Guidelines of the Dutch Association of General Practitioners (NHG) dictate the evalu ation, treatment, and referral process of pa tients with stable chest pain syndromes (CPS). Adherence to this guideline was assessed in a consecutive group of patients referred to our hospital. Methods. We retrospectively studied the records of 296 subjects referred to our outpatient de partment in 2007 for evaluation of stable CPS. Referral letters were checked for complete ness (past and present history, mentioning of risk factors for cardiovascular disease, physical exam ination, listing of medication) and used to judge adherence to the guideline. In a subset of patients, additional information regarding the referral process was gathered by telephone in terview. Results. The referral letter was complete in only 67 patients (23%); items most often not reported were physical examination (63%) and cardiovascular risk factors (62%). Judging from the referral letter, 23 patients (8%) were evalu ated in accordance with the NHG guideline prior to their referral. In patients in whom the final diagnosis of angina pectoris was made by the cardiologist, this was 20%. Seventy nine pa tients were contacted by telephone after their work up by the cardiologist; 36 of them (44%) reported being referred at their first visit to their primary physician, while 14 (18%) were referred at their own request. Conclusion.Prior to referral, only a minority of patients with stable CPS were evaluated and treated in accordance with NHG guidelines. Furthermore, their referral letter was often in complete. (Neth Heart J 2010;18:178 82.)