In October of 2018, the Gold Coast University Hospital (GCUH) swapped from using a troponin I test (reference level <0.4) to using a high sensitivity troponin I test (reference level <10 in females and <20 males) for evaluation of suspected cardiac chest pain. To determine the impact of the introduction of the high sensitivity troponin test, an audit was conducted. Coronary angiograms performed at the GCUH to investigate a troponin elevation over a 12-month period (6 months prior to and post the adoption of HscTnI) were recorded and analysed. Coronary Angiograms performed for ST elevation myocardial infarction were excluded. An angiogram was considered positive for severe coronary artery disease (CAD) if a 70% or greater stenosis in 1 or more epicardial vessels was found or operator opinion that percutaneous intervention or surgical intervention was warranted. 338 coronary angiograms were performed in the 6 months prior to the adoption of HscTnI. Of these cases, 263 angiograms were positive for severe CAD. 351 coronary angiograms were performed in the 6 months since the adoption of HScTnI. Of these cases, 232 angiograms were positive for severe CAD. The use of the high sensitive troponin test resulted in an increase in the number of coronary angiograms performed with a decreased proportion of angiograms positive for severe CAD.