[Rapid assessment of thoracic pain. Is it a myocardial infarct?].

The high mortality rate of acute myocardial infarction underline the importance of this entity in the differential diagnosis of acute chest pain. Medical history, clinical presentation, ECG, biochemical markers of myocardial injury and imaging techniques are used to establish a correct diagnosis. Myocardial infarction can be divided into ST-segment elevation myocardial infarction and non-ST-segment elevation myocardial infarction. In the case of ST-segment elevation myocardial infarction thrombolytic therapy or percutaneous transluminal coronary angioplasty should be instituted as soon as possible. In patients without persistent ST-segment elevation biochemical markers of myocardial damage, especially troponin T and troponin I, are of major importance for risk stratification. Patients with elevated troponin levels should be treated with GPIIb/IIIa antagonists and early intervention.