Question

An otherwise healthy 58-year-old presents to the ED with 2 hours of substernal pressure radiating to the left arm. ECG shows no ischemic changes. A high-sensitivity cardiac troponin T (hs‑cTnT) at presentation is below the 99th percentile for the assay. He is pain-free after aspirin. Vital signs are normal. What is the most appropriate next step to safely disposition this patient?

Accepted Answer

Obtain a repeat hs‑cTn using a validated 0/1‑hour algorithm and integrate into a clinical decision pathway

Answer

Discharge now because the single hs‑cTn is negative

Answer

Admit for routine stress testing within 24 hours

Answer

Give clopidogrel and heparin and take to emergent angiography

Answer

Order a D‑dimer to exclude type 1 MI

Practice question