Early evaluation of cardiac chest pain always been a challenge in Pre-hospital as well as in emergency department. Patient history of chest pain, 12 Leeds electrocardiogram & cardiac markers are important in making a diagnosis of acute coronary syndrome. Dilemma happens while having chest pain doing sports & nonspecific ECG, also base line increase in the cardiac markers. It's not only a stressful state for the patient but occupancy of a busy emergency room and burden to the hospital. This book will provide expertise to medical interns, residents, physicians and sports medicine specialists.