A 61-year-old man with chest pain has dynamic ST depression in V4–V6 and troponin rise from 42 to 420 ng/L. He is pain-free after nitrates, BP 126/74

Question

A 61-year-old man with chest pain has dynamic ST depression in V4–V6 and troponin rise from 42 to 420 ng/L. He is pain-free after nitrates, BP 126/74 mmHg and has no heart failure. GRACE score is high. What is the most appropriate next step in management?

Accepted Answer

Arrange angiography within 24 hours with acute coronary therapy

Answer

Use medical treatment followed by outpatient functional imaging

Answer

Arrange angiography only if chest pain or ECG changes recur

Answer

Use CT coronary angiography as the initial anatomical test

Answer

Arrange immediate fibrinolysis followed by coronary angiography

Non-ST elevation myocardial infarction — SCE Acute Medicine MCQ

A 61-year-old man with chest pain has dynamic ST depression in V4–V6 and troponin rise from 42 to 420 ng/L. He is pain-free after nitrates, BP 126/74 mmHg and has no heart failure. GRACE score is high. What is the most appropriate next step in management?