Cardiac biomarkers for rapid evaluation of chest pain.

Physicians caring for acute chest pain patients constantly maneuver between unnecessary admissions and premature discharges. The ECG is the most readily available tool for identifying patients with ST-segment elevation, who are likely to have myocardial infarctions and who should receive reperfusion treatment. Establishing the correct diagnosis in the patients without ST-segment elevation, however, can be much more challenging. Undetected infarctions remain a serious public health issue and represent the leading cause of malpractice cases in the emergency room setting.1 Prematurely discharged patients often have been seen by physicians with less professional experience. Such patients frequently have more atypical complaints and nondiagnostic ECG findings, are younger, and are at higher risk than admitted patients.1,2