This presentation will give you an update of the current chest pain protocols; including risk scores (HEART, TIMI, EDACS) with / without high sensitive troponin. But also on the newer pathways with rule out of acute coronary syndrome with a high sensitive troponin below the limit of detection or two troponins with a delta. How do we use these chest pain protocols in tomorrow’s clinical practice? How do you choose a protocol that fits in your institution? Which chest pain patient can we discharge safely from the emergency department and for whom should we organize outpatient follow up? And how do you share your decision with the patient in front of you.