Coronary artery disease Quiz: Ace Your Exams

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A 62-year-old man presents to the emergency department for evaluation of chest pain. The patient reports that he was lifting heavy boxes at work when he suddenly became nauseous, and sweaty, and developed substernal chest discomfort radiating down his left arm. The patient states that the pain has been persistent. Past medical history includes hypertension, hyperlipidemia, diabetes, and a 10-pack year smoking history. Temperature is 37°C (98.6°F), blood pressure is 100/71 mmHg, pulse is 89/min, respiratory rate is 14/min, and oxygen saturation is 99% on room air. The patient appears clammy and pale. Physical examination is otherwise unremarkable. Defibrillator pads are placed, and IV access is established. Initial laboratory results and electrocardiogram are shown below. A platelet P2Y12 receptor blocker is administered. Which of the following is the next best step in management?  

 Laboratory value  Result 
 Complete Blood Count (CBC) 
 Hemoglobin  13 g/dL 
 White blood cell count (WBC)  16,000/mm3 
 Serum chemistry 
 Troponin  120 ng/mL  


Reproduced from: Wikipedia 

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