Chart, page-63

Hi Swami2

Most people do not have chest pain in front of the ED.

They sit at home denying there is a problem, thinking it is indigestion or a strained muscle or something else.

By the time they call in to see someone it is generally some time after onset of symptoms starting.

I understand your point around 'ruling out' although where I think the advantage is with a finger prick lab sensitive 5 minute test is to 'rule in' and get the patient into the Cath lab ASAP.

The troponin levels should keep rising for the first 6 hours.

Thus the repeat testing to establish the rule out.

The higher the sensitivity of the testing then the greater chance of detecting fluctuations to rule out.

I know it is a bit old but try looking at this 2012 article that is looking at a 1 hour retest with a high sensitive troponin test. But with a TAT of 1 hour I wonder what the use is.

http://archinte.jamanetwork.com/Mobile/article.aspx?articleid=1309579

There are health services who now have an accelerated pathway of 2 hour testing to try and get people out of ED.

Anyway it's a nice day to top up