Context

Low risk chest pain presents the Emergency Physician with a classic diagnostic challenge. The need to identify and treat a minority of patients with potentially life-threatening pathology (AMI), must be weighed against the need to avoid unnecessary diagnostic testing, or hospital admission, for the majority of patients who have benign pathology.

There is no simple solution to this challenge, and occasional misdiagnosis is inevitable, but armed with knowledge of the strengths and limitations of available diagnostic tests, and understanding of the principles of applying them to patients and populations, we can maximise the chances of providing appropriate care.