A 58-year-old with 3 hours of pressure-like chest pain and a normal ECG has an initial high-sensitivity troponin I below the assay's limit of quantita...

Question

A 58-year-old with 3 hours of pressure-like chest pain and a normal ECG has an initial high-sensitivity troponin I below the assay's limit of quantitation (LoQ) and symptoms began >3 hours before arrival. Best next step?

Accepted Answer

Repeat hs-cTn according to institutional rapid pathway and use a validated decision pathway

Answer

Discharge with no further testing or follow-up

Answer

Admit for invasive angiography within 2 hours

Answer

Give thrombolysis now

Answer

Start heparin infusion immediately

us-usmle-step-2 MCQ (SBA): Acute Coronary Syndrome evaluation

A 58-year-old with 3 hours of pressure-like chest pain and a normal ECG has an initial high-sensitivity troponin I below the assay's limit of quantitation (LoQ) and symptoms began >3 hours before arrival. Best next step?