2020Emergency Medicine AustralasiaRequires access

High‐sensitivity troponin T use in non‐chest pain presentations in the emergency department

Paul Buntine, Serena Sze, Emogene S Aldridge

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Abstract

OBJECTIVE: To explore troponin testing yield in patients who present to the ED without chest pain. METHODS: A retrospective medical record audit of all patients who presented to ED in November 2018 and had troponin measured. RESULTS: A total of 1124 troponin assays were performed in 763 patients, 48.7% had no documented chest pain; 8.8% of these met high-risk criteria and 1.1% were diagnosed with acute coronary syndrome. CONCLUSIONS: Despite ED troponin testing in the absence of chest pain being common practice, it rarely assisted in a meaningful diagnosis. Consequences of testing may include delays to patient discharge and additional downstream testing.

About this research paper

What this paper is about

OBJECTIVE: To explore troponin testing yield in patients who present to the ED without chest pain. METHODS: A retrospective medical record audit of all patients who presented to ED in November 2018 and had troponin measured. RESULTS: A total of 1124 troponin assays were performed in 763 patients, 48.7% had no documented chest pain; 8.8% of these met high-risk criteria and 1.1% were diagnosed with acute coronary syndrome. CONCLUSIONS: Despite ED troponin testing in the absence of chest pain being common practice, it rarely assisted in a meaningful diagnosis. Consequences of testing may include delays to patient discharge and additional downstream testing.

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Available abstract

OBJECTIVE: To explore troponin testing yield in patients who present to the ED without chest pain. METHODS: A retrospective medical record audit of all patients who presented to ED in November 2018 and had troponin measured. RESULTS: A total of 1124 troponin assays were performed in 763 patients, 48.7% had no documented chest pain; 8.8% of these met high-risk criteria and 1.1% were diagnosed with acute coronary syndrome. CONCLUSIONS: Despite ED troponin testing in the absence of chest pain being common practice, it rarely assisted in a meaningful diagnosis. Consequences of testing may include delays to patient discharge and additional downstream testing.

Key concepts: Medicine, Chest pain, Emergency department, Troponin, Acute coronary syndrome, Audit, Troponin T, Medical record

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