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August 2025

RCEM Learning

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Ruling Out Acute Coronary Syndrome in Emergency Care

This chapter explores current strategies for ruling out Acute Coronary Syndrome (ACS) in UK emergency departments, focusing on high-sensitivity troponin assays and their impact on patient management. It highlights the findings from an observational study involving 94 emergency departments, emphasizing challenges such as overcrowding and resource allocation. The discussion also reflects on the importance of timely testing, clinical judgment, and the differences in practices between the UK and US regarding troponin testing protocols.

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