Troponin-negative chest pain: who needs further testing?


Your patient had chest pain. You’re happy that you’ve ruled out respiratory causes, aortic dissection and acute MI.    Their ECG shows no ischaemia and troponin is not raised. So what now?

In the majority of cases, of course,  this patient can go home. The question is, what kind of follow up does he or she need? And how quickly should it happen? In short, is there a way you can estimate the risk of cardiac events and what level of risk is acceptable?

The paper

American College of Emergency Physicians Clinical Policies Subcommittee (Writing Committee) on suspected non-ST elevation acute coronary syndromes, et al. Clinical policy: critical issues in the evaluation and management of emergency department patients with suspected non-ST-elevation acute coronary syndromes. Ann Emerg Med. 2018 Nov;72(5):e65-e106​[1]


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