40 years old obese patient, smoker (20 cigarettes a day) presents with 3 hours of retrosternal chest pain which improves with rest. He has a past history of intermittent chest pain, which improved with rest or nitroglycerine. His pain is improving as you see him. He belched and felt better. Initial cardiac enzymes are normal. What is the next step in management (this would be mastery question):
- refer to gastroenterologist
- send him home with reassurance asking him to come next day
- arrange an immediate exercise stress test
- admit him to CCU and monitor his ECG and do serial cardiac enzymes
- send him home and ask him to come when worse
No comments:
Post a Comment