Question

A 58-year-old presents with 2 hours of chest pain. Initial ECG is non-ischemic. High-sensitivity cardiac troponin (hs‑cTn) at 0 hour is below the assay's limit of quantitation; symptoms began >3 hours ago and risk is low. Best next step?

Accepted Answer

Repeat hs‑cTn in 1-3 hours and discharge if unchanged below threshold

Answer

Discharge now with outpatient stress testing within 72 hours

Answer

Admit for serial conventional troponin testing at 0 and 6 hours

Answer

Start heparin infusion and admit to coronary care unit

Answer

Immediate invasive coronary angiography

Practice question

A 58-year-old presents with 2 hours of chest pain. Initial ECG is non-ischemic. High-sensitivity cardiac troponin (hs‑cTn) at 0 hour is below the assay's limit of quantitation; symptoms began >3 hours ago and risk is low. Best next step?