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

question 885

Multiple Choice

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

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Definitions:

Case Managers

Professionals who coordinate care and resources for individuals with complex health needs, facilitating access to necessary services.

Social Therapists

professionals who use therapeutic techniques within a social framework to improve individuals' mental health and interpersonal relationships by focusing on social dynamics and support systems.

Business Managers

Individuals responsible for overseeing and directing the operations within a business to meet its goals.

Psychological Disorders

Mental disorders comprising various psychological symptoms that cause significant distress or impairment in social, occupational, or other important activities.