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Background: Cardiovascular disease is the first cause of morbidity and mortality in the West and the second cause of death in Colombia; it is important to find out the relationship established between electrocardiographic, enzymatic and clinical findings in patients who consult with chest pain to an emergency department of Manizales city, Colombia, with this disease suspected. Materials and Methods: A cross-sectional study was performed during 2009, in which 286 medical records where analyzed which formed the study sample, evaluating demographic variables, pain characteristics, ECG findings, enzyme values, and risk factors. Results: It was found in the ACE 24.1% of positive troponin, 15.5% positive total CK, 6.9% Positive CK-MB and positive ECG 91.1%; in the diagnosis of AMI the CKMB was positive in 18.2%, positive total CK in 45.5%, positive troponin in 68.2% and ECG was positive in 100% of the cases. 35% of patients with diagnosis of non ACE had positive troponin, positive total CK in 33.3% and positive CK-MB in 21.1%, being able to attribute this to comorbidities. Conclusions: The low sensitivity and specificity demonstrated by the cardio enzymes in the study could be due to the inadequate sample because its elevation starts at 3 to 4 hours as demonstrated in several studies. The cardio enzymes and electrocardiographic and clinical findings are still very important when ischemic heart disease is suspected, its diagnosis and management. [ABSTRACT FROM AUTHOR]