![]() The advent of bedside tests, also called point-of-care (POC) tests, in which the blood tests are done near the patient location, has revolutionized the care provided to patients, especially in Eds. However, most of the hospitals fail to meet the recommended turnaround time of less than 60 min from the time blood is drawn until the reporting of the final results. Measurement of cardiac markers in the blood is key in the evaluation of patients presenting with chest pain to ED. ![]() 6, 7 Since cardiac markers are tested in a central laboratory, which is outside the ED, the diagnosis of ACS is delayed. 2 – 5 In up to 50% of patients with non-diagnostic ECG, the diagnosis of acute MI depends on troponin tests. Cardiac markers are important for identifying ACS in the absence of typical ECG changes in patients with chest pain. Early diagnosis of ACS with early initiation of treatment leads to reduce mortality hence appropriate risk stratification, triaging, and early treatment plan for chest pain is of utmost importance in the ED.Įvaluation and risk stratification of chest pain patients depends on clinical symptom and signs, ECG, and cardiac enzymes. Diagnosing ACS is a challenging task for ED physicians. Electrocardiogram (ECG) can differentiate between STEMI and NSTEMI, while cardiac troponin can differentiate between NSTEMI and UA when ECG is nonspecific or normal. ACS consists of ST-elevation myocardial infarction (STEMI), non-ST elevation myocardial infarction (NSTEMI), and unstable angina (UA). 1 Causes of chest pain vary from non-significant musculoskeletal pain to life-threatening acute coronary syndrome (ACS) and pulmonary embolism, as examples. Chest pain accounts for 5–20% of all ED visits. ![]() Chest pain is one of the most common symptoms in patients visiting the emergency department (ED) worldwide. ![]()
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