What should be done when the initial ECG is not diagnostic but the patient remains symptomatic and there is a high clinical suspicion for ACS?
Serial ECGs (eg, 15- to 30-minute intervals during the first hour) should be performed to detect ischemic changes, and serial cardiac troponin I or T levels should be obtained at presentation and 3 to 6 hours after symptom onset. Additionally, risk scores should be used to assess prognosis in patients with NSTE-ACS.