Tudor Hart describes the real stuff of primary medical care as the steady unglamorous slog of anticipatory care, where the exciting things have been events that have not happened.1 When acute events do occur, as in this case, the electronic responses from Bossano and Trivanovic rightly highlight the difficulties in diagnosing chest pain in the community without access to sophisticated investigations.2

Good consultation skills are always important. Peter Hartl's description of his pain before admission …