TIMI score and a single baseline troponin for safe discharge of chest pain patients

Chest pain is a common complaint among patients at the emergency department (ED) and accounts for about 5–10% of all ED visits (1). The list of differential diagnoses is long, but it is normally the perceived likelihood of acute coronary syndrome (ACS), i.e., acute myocardial infarction (AMI) or unstable angina (UA) that drives management. The fear of missing cases of ACS leads to lengthy ED assessments and high admission rates for serial troponin samples and non-invasive testing or coronary angiography (2,3). In the end however, less than 25% of all admitted chest pain patients prove to have ACS (2,4). There is thereby room for significant improvement in our assessment of chest pain patients.