So, you think a normal set of serial trops and ECGs rules out MI? Negative D-dimer and negative CTPA rules out PE, right?
Think again, minimise the risk as much as you can in the confines of the available technology and your clinical acumen, accept the risk, move on, and sleep well at night – THERE IS NO SUCH THING AS A “RULE-OUT!”
Don’t be scared, but do be aware of risk on discharge. Remember, we don’t change the REAL mortality rate – it has been constant since the dawn of time at one per person – we just occasionally affect the timing!
This post of mine is really an attempt to share a fantastic post by @DrGDH on this idea of acceptance of risk in Emergency Medicine: