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Medicine Acute coronary syndrome 614007a1

A 23-year-old male developed an excruciating chest pain and palpitations after drinking 4 cans of energy drink at night while revising for final year exams. He was brought to ED, and his ECG showed sinus tachycardia but no ST change. Pulse was 90/min and BP was 130 /90 mm Hg. The pain subsided after a sho while. His physical examination was normal. He gave a history that last year his father had a myocardial infarction at the age of 60. All his lab findings were in a normal range. Troponin and D-dimer tests came out to be negative. What shall be the next step in management?

A
Closely observe and monitor
B
Put him on exercise treadmill test
C
Do a Stress echocardiogram
D
No fuher investigation is required
High-Yield Explanation
The symptoms of chest pain and palpitations has developed in the patient due rapid adrenaline gush in his system due to energy drink. As ECG shows, no ST elevation, it rules out STEMI. This patient currently has a very low risk of coronary disease and so no fuher ischaemic stratification is necessary. In view of family history, primary prevention is of utmost impoance.

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