It’s a busy night shift and you are running on all cylinders. You are assessing a 21-year-old gentleman with chest pain of a few minutes’ duration, with no past medical history or family history of cardiovascular disease. He is a non-smoker and reports no recreational drug use. The gentleman is currently symptom free, examines well and has a normal ECG. His bloods were sent without a troponin and you wonder can you safely exclude acute coronary syndrome without sending a troponin.