Troponin testing in the primary care setting.

BACKGROUND: Chest pain is a common presenting complaint in general practice. Serum troponin testing is an important clinical tool to help identify patients who present with suspected acute coronary syndrome (ACS).

OBJECTIVE: This article will discuss the role of troponin testing in the diagnosis of ACS, and the role of high-sensitive troponin, which is now in widespread use. The importance of clinical acumen in the interpretation of troponin testing and the pitfalls of troponin testing in the primary care setting will also be explored.

DISCUSSION: Patients should be promptly referred to the hospital when there is a high clinical suspicion of ACS. This is to ensure early diagnosis, provide specialist care and minimise the risk of complications. For patients who present with suspected ACS, troponin testing in the community should not delay referral to the emergency department. Troponin testing has a limited role in the primary care setting, which will be discussed in this article.