Question

A 60-year-old man presents with exertional chest pain. You practise in a small rural town without onsite stress testing or CT coronary angiography. He has normal resting ECG and no red-flag features. What is the most appropriate next step?

Accepted Answer

Refer for the nearest available non-invasive functional or anatomical cardiac test (such as stress echocardiography or CT coronary angiography)

Answer

Start long-term opioids for pain control

Answer

Arrange urgent transfer to tertiary hospital for invasive angiography as first-line

Answer

Reassure without further testing

Answer

Start high-dose beta blocker and statin without any diagnostic evaluation

Practice question

A 60-year-old man presents with exertional chest pain. You practise in a small rural town without onsite stress testing or CT coronary angiography. He has normal resting ECG and no red-flag features. What is the most appropriate next step?