title: Clinical presentation and ECG changes--how good is it in diagnosing troponin positive acute coronary syndrome.
abstract: To study the relation between troponin positive acute coronary syndrome (ACS) and electrocardiogram (ECG) changes on admission.
  
  
  METHODS
  It was a prospective cohort study looking at patients admitted to the Heart Assessment Center over a period of a month, who were suspected to have an ACS. There were 126 patients in the cohort. The groups were classified depending on the number of cardiovascular risk factors: 0, 1, 2, 3, 4 and >4. The history and ECG changes during presentation were analyzed and the cardiac enzymes (12-hour troponin) were done. The final diagnosis was based on the expert opinion of the Consultant Cardiologist in combination with troponin positive results, and they were only further studied.
  
  
  RESULTS
  Of the 126 patients that were analyzed 31(25%) were diagnosed as ACS of which 26(21%) were troponin positive ACS. Among them, 13(50%) had ECG changes during admission, and 13(50%) did not have any noticeable ECG changes.
  
  
  CONCLUSIONS
  Certain elements of the chest pain history and ECG changes are associated with increased or decreased likelihood of a diagnosis of ACS, none of them alone or in combination identify a group of patients that can be safely discharged without further diagnostic testing.
authors.affiliation: University Hospital Aintree, Liverpool, UK.
authors.forename: Anthony Leslie
authors.initials: AL
authors.lastname: Innasimutthu
authors.forename: Sandeep Shivananada
authors.initials: SS
authors.lastname: Siddhi
authors.forename: Gopala Krishna Balappa
authors.initials: GK
authors.lastname: Rao
mesh_terms: D015415:Biomarkers / Q000097:blood; D015331:Cohort Studies; D004562:Electrocardiography; D006801:Humans; D009203:Myocardial Infarction / Q000097:blood / Q000175:diagnosis*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D014336:Troponin / Q000097:blood*
chemical_list: D015415:Biomarkers; D014336:Troponin