Question 29

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A 32-year-old otherwise healthy man presents with acute onset of epigastric pain radiating to his chest that woke him from sleep at 2 am. It was a burning pain associated with water brash.

There were no associated pulmonary symptoms. His past medical history is negative except for tobacco use and heartburn. His electrocardiogram is normal and his upright chest radiograph is also normal. Vital signs and physical examination findings are unremarkable. He is currently pain-free. His troponin level is normal.

What would be the most appropriate intervention?

  • A. Cardiology consultation for catheterization
  • B. Contrast-enhanced CT scan of the chest
  • C. Trial of proton pump inhibitors (PPI)
  • D. Serial troponins
  • E. Discharge on aspirin, 325 mg once daily