Question

A 59-year-old man presents 1 hour after sudden onset central crushing chest pain radiating to his left arm. His ECG is non-diagnostic, but high-sensitivity troponin at presentation is normal. He has ongoing pain and is haemodynamically stable. What is the most appropriate next step?

Accepted Answer

Repeat troponin at 3 hours and manage as suspected acute coronary syndrome

Answer

Discharge home with reassurance as the troponin is normal

Answer

Arrange elective outpatient exercise testing

Answer

Give thrombolysis immediately

Answer

Start long-term proton pump inhibitor therapy and review in 4 weeks

Practice question

A 59-year-old man presents 1 hour after sudden onset central crushing chest pain radiating to his left arm. His ECG is non-diagnostic, but high-sensitivity troponin at presentation is normal. He has ongoing pain and is haemodynamically stable. What is the most appropriate next step?