You suspect your patient’s chest pain is cardiac. Should you activate the cath lab?

Below is an algorithm that has been discussed on wards several times. It incorporates the new acute coronary syndrome guidelines with a modification based on the OMI (occlusive MI) model.

The new guidelines, which have not adopted the OMI model, are liked here:

2025 ACC/AHA/ACEP/NAEMSP/SCAI Guideline for the Management of Patients With Acute Coronary Syndromes: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines