Cardiac enzymes in the evaluation of chest pain.

All patients presenting to a community hospital with a complaint of "chest pain" were analyzed regarding the value of cardiac enzyme determinations done in the emergency department and eventual disposition to admission or discharge. The laboratory enzyme tests were found to be of no value in the decision-making process. The majority of patients had either a more compelling reason for dismissal home or historical and electrocardiographic indications mandating admission. An isolated emergency department enzyme evaluation was shown to be a poor indicator for subsequent infarction in patients who were admitted. While cardiac enzymes play a significant role in the monitoring and evolution of infarction in the hospitalized patient, there seems to be no justification for their being run on a stat basis in the emergency department.