Point-Of-Care Testing and Therapy (POCT-T) For Suspected Acute Coronary Syndrome inRemote Settings Smartphone ECG Plus Rapid LFIA Troponin

Background: Rapid diagnosis and early treatment of Acute Coronary Syndrome (ACS) remain challenging outside hospital environments. We implemented a pragmatic Point-of-Care Testing and Therapy (POCT-T) model combining smartphone electrocardiography KardiaMobile ECG (KM-ECG) and semi-quantitative lateral-flow immunoassays (LFIA) for cardiac troponin, tailored for maritime and other remote operations. Methods: We describe the technology stack (KardiaMobile ECG and LFIA troponin), summarize published accuracy data, and propose an operational workflow to reduce time-to-diagnosis and time-to-treatment. Literature was reviewed on smartphone ECG performance for ST-segment elevation myocardial infarction (STEMI), prehospital ECG transmission programs, and rapid LFIA troponin tests. Key endpoints were diagnostic accuracy and estimated time intervals from symptom onset to first ECG, biomarker result, activation decision, and reperfusion. Results: Sequential smartphone ECG leads (≥2 including a precordial position) showed high sensitivity and specificity for STEMI detection in a prospective study, whereas single-lead alone was modestly sensitive (De la Torre Hernández et al., 2021). LFIA troponin provides a qualitative/semi-quantitative result in ~10–15 minutes, with utility growing beyond the first hours from symptom onset but lower sensitivity than high-sensitivity quantitative assays (Collinson & Gaze, 2020; Roche Diagnostics, 2025; Mohammadinejad et al., 2024). Prehospital ECG transmission programs consistently reduce door-to-device times and facilitate earlier activation of PCI pathways (Moxham et al., 2024). A combined KM+LFIA workflow can anticipate diagnostic confirmation by tens of minutes compared with hospital-only pathways, potentially shortening total ischemic time. Conclusions: In resource-limited or remote environments, coupling smartphone ECG with rapid LFIA troponin is feasible, low-cost, and operationally impactful. This POCT-T approach may accelerate early antiplatelet therapy and targeted evacuation while preserving clinical oversight via teleconsultation (Byrne et al., 2023; Gulati et al., 2021).