1st-order laboratory parameters-obligatory laboratory tests.
- Small blood count
- Inflammatory parameters – CRP (C-reactive protein) or ESR (erythrocyte sedimentation rate).
- Highly sensitive cardiac troponin T (hs-cTnT) or troponin I (hs-cTnI) – for suspected myocardial infarction (heart attack); if hs-cTnT and ECG negative, then only 1.5% of all myocardial infarctions are missed
- D-dimers – for suspected thrombosis or pulmonary embolism.
Laboratory parameters 2nd order – depending on the results of the history, physical examination and the obligatory laboratory parameters – for differential diagnostic clarification.
- Blood gas analysis (ABG), arterial.
- Liver parameters – alanine aminotransferase (ALT, GPT), aspartate aminotransferase (AST, GOT), bilirubin.
- Renal parameters – urea and creatinine, creatinine clearance if necessary.
- Pancreatic diagnostics (diagnostics of the pancreas) – amylase, elastase and lipase.
- Copeptin (synonym: C-terminal proAVP, CT-proAVP; glycosylated peptide consisting of 39 amino acids, which together with vasopressin (also called AVP or antidiuretic hormone; N: < 10 pmol(L; hemodynamic marker) [typically elevated in hemodynamic instability).
Note: Acute chest pain without clinical signs of ischemia on ECG and normal troponin test does not warrant coronary CT (CCTA) and/or exercise testing to rule out acute coronary syndrome (ACS).
