Hi Swami2 Most people do not have chest pain in front of the ED....

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