A 58-year-old man presents to a small rural hospital with chest pain suggestive of unstable angina. Troponin assays and cardiology services are not av...

Question

A 58-year-old man presents to a small rural hospital with chest pain suggestive of unstable angina. Troponin assays and cardiology services are not available on site. His ECG shows dynamic ST depression. After initial management with aspirin and nitrates, what is the most appropriate strategy?

Accepted Answer

Arrange urgent transfer to a higher-level facility for troponin testing and cardiology assessment

Answer

Discharge with GP follow-up in 1 week

Answer

Admit for observation only without transfer

Answer

Wait overnight and transfer only if pain recurs

Answer

No further action is required if initial ECG is non-diagnostic

au-acem MCQ (SBA): Rural acute coronary syndrome management

A 58-year-old man presents to a small rural hospital with chest pain suggestive of unstable angina. Troponin assays and cardiology services are not available on site. His ECG shows dynamic ST depression. After initial management with aspirin and nitrates, what is the most appropriate strategy?