Question

An adult presents to the ED with 2 hours of non‑exertional chest pressure. Vitals are normal. ECG is non‑ischemic. Two high‑sensitivity troponin I values at 0 and 2 hours are below the assay limit of detection with a delta <3 ng/L. HEART score is 2. What is the most appropriate next step?

Accepted Answer

Discharge with shared decision‑making and prompt outpatient follow‑up; no urgent in‑hospital testing

Answer

Admit for observation and routine stress testing within 24 hours

Answer

Give loading doses of aspirin and clopidogrel and arrange urgent PCI

Answer

Order coronary CT angiography prior to discharge

Answer

Initiate heparin infusion and telemetry admission

Practice question

An adult presents to the ED with 2 hours of non‑exertional chest pressure. Vitals are normal. ECG is non‑ischemic. Two high‑sensitivity troponin I values at 0 and 2 hours are below the assay limit of detection with a delta <3 ng/L. HEART score is 2. What is the most appropriate next step?