My client presented to the ER with symptoms of chest pain. After a physical exam, the ER physician attributed the chest pain to acid reflux disease and sent him home with a prescription for Nexium. No blood work was done in the ER to measure cardiac enzyme levels. Several hours later, my client suffered a major heart attack. I need authoritative literature published in emergency medicine journals which discusses the standard of care for an ER physician to rule out chest pain of cardiac origin as opposed to non-cardiac chest pain.