A 56-Year-Old Hospitalized Man Is Evaluated for Recurrent Chest Pain

A 56-year-old hospitalized man is evaluated for recurrent chest pain.  The patient was admitted 3 days ago due to a 1-day history of precordial chest pain.  Evaluation revealed acute myocardial infarction and a drug-eluting stent was placed in the left anterior descending artery.  His symptoms had resolved after the procedure but today the patient experienced sharp chest pain radiating to his left shoulder.  He could only get comfortable sitting up but has had no orthopnea or palpitation.  Current medications include aspirin, prasugrel, metoprolol, and rosuvastatin.  Temperature is 37.2 C (99 F) , blood pressure is 112/70 mm Hg, and pulse is 101/min and regular.  Physical examination shows no heart murmurs and the lungs are clear bilaterally.  ECG shows sinus tachycardia and widespread PR-segment depression.  Which of the following is the best next step in management of this patient?

A) Coronary angiography
B) CT pulmonary angiography
C) Echocardiography
D) Exercise stress testing
E) Serum troponin level

Correct Answer:

Verified

Unlock this answer now
Get Access to more Verified Answers free of charge

Access For Free