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The evaluation of patients with chest pain and/or dyspnoea is a routine part of primary care practice. These cardinal symptoms can be caused by the following diseases and disorders: stable angina pectoris, infections of the upper respiratory tract, myocardium or pericardium, pneumothorax, exacerbated COPD, gastrointestinal disease, musculoskeletal pain and panic disorder. The three most important differential diagnoses are Acute Coronary Syndrome (ACS), Heart Failure (HF) and Venous Thromboembolism (VTE). Establishing a reliable primary care diagnosis on the basis of clinical findings and the readily available diagnostic tools, such as ECG and X-ray, can be difficult. A number of useful cardiovascular biomarkers help facilitate the diagnosis and more are currently under development. The most frequently employed biomarkers in this context are cardiac troponin T (cTnT), N-terminal pro-brain natriuretic peptide (NT-proBNP) and D-dimer. New multifunctional devices are capable of measuring all three in a matter of minutes.
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