Patients who develop recurring chest pain consistent with myocardial ischaemia, ST segment elevation or depression on continuous 12 lead ECG monitoring indicating myocardial necrosis, or have positive CKMB (> 5), Troponin T (> 0.01), were admitted to the Department of Cardiology. If the patient was not admitted at the end of 6 hours, he/she were reviewed by a ED Registrar/Associate Consultant/Consultant. The senior ED doctor reviewed the patient, his/ her 12 lead ECGs and blood results for serum markers for myocardial necrosis.