The use of 12 lead electrocardiography and cardiac troponins in the diagnostic evaluation of suspected acute coronary syndrome. *It is unusual to find serial negative troponins in suspected acute coronary syndrome patients whose electrocardiograms show persistent ST segment elevation. The use of 12 lead electrocardiography and cardiac troponins in the diagnostic evaluation of suspected acute coronary syndrome. *It is unusual to find serial negative troponins in suspected acute coronary syndrome patients whose electrocardiograms show persistent ST segment elevation. G A Large Postgrad Med J 2005;81:217-222 Copyright © The Fellowship of Postgraduate Medicine. All rights reserved.