“Troponin-negative chest pain”—a diagnostic evasion?

BMJ 2012; 344 doi: (Published 09 May 2012) Cite this as: BMJ 2012;344:e1682
  1. Ibrahim Ali, foundation year 2 doctor, Hillingdon Hospital, London
  1. ibrahim.ali04{at}

Having completed attachments in acute medicine and cardiology, I have seen quite a few patients presenting with chest pain. In the vast majority of cases, the diagnosis is acute coronary syndrome, but I have also seen patients with diagnoses of pericarditis, aortic stenosis, aortic dissection, and pulmonary embolism to name but a few examples.

However, I have also seen many patients who present with chest pain that has the appearance of an acute cardiac …

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