A 52-year-old with 3 hours of intermittent substernal discomfort has a normal ECG. High-sensitivity troponin T at 0 and 2 hours are both below the 99t...

Question

A 52-year-old with 3 hours of intermittent substernal discomfort has a normal ECG. High-sensitivity troponin T at 0 and 2 hours are both below the 99th percentile with a delta

Accepted Answer

Discharge with outpatient follow-up and no in-hospital testing

Answer

Exercise treadmill test prior to discharge

Answer

Begin therapeutic unfractionated heparin infusion

Answer

Admit for observation with 6-12-hour conventional troponins

Answer

Immediate coronary CT angiography

us-abem MCQ (SBA): Chest Pain Risk Stratification

A 52-year-old with 3 hours of intermittent substernal discomfort has a normal ECG. High-sensitivity troponin T at 0 and 2 hours are both below the 99th percentile with a delta <3 ng/L. HEART score is 2. He is pain-free and hemodynamically stable. What is the most appropriate next step?