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Abstract: 

There are few things in medicine that make me clench my jaw more than having to evaluate a patient with chest pain. This presentation has all the necessary ingredients of a disaster: A large differential diagnosis; No clear physical signs or symptoms to sort it out; Large risk of harm or even death if misdiagnosed; Expensive and time intensive to investigate; and Low probability of acute life-threatening disease in any single presentation.To make it worse, chest pain leads the list of medical issues that cause what I call “societal denial syndrome.” Our society generally does not want to deal with the anxiety caused by knowing that doctors usually cannot definitively diagnose a life-threatening disease within the first hours.

Keywords: cardiac markers, artificial neural networks, triage, myocardial infarction, Pulmonary embolism, Pneumonia, Pneumothorax, Esophageal rupture, Thoracic aortic dissection

Affiliations:  1: Ohio Department of Rehabilitation and Correction.