ER nurse here - some STEMIs I've taken care of had negative initial trop's (not all though). The 4 hr delta should of course be positive though - I don't typica

ER nurse here - some STEMIs I've taken care of had negative initial trop's (not all though). The 4 hr delta should of course be positive though - I don't typically check the 4 hr repeat for STEMIs though because they're long gone out of the ED to the cath lab then to CVICU.