Cardiology>>>>>Ischaemic heart disease
Question 9#

A 25-year-old male developed sharp central chest pain and palpitations after drinking three cans of energy drink whilst revising for exams. The symptoms were ongoing when he initially attended the ED, and an ECG showed a sinus tachycardia with no ST change. The pain subsided shortly afterwards. He is normally fit and well. His father recently had a myocardial infarction at the age of 62. All observations and examination are normal. Troponin and D-dimer tests were negative.

What would you recommend?

a. Admit for observations
b. Exercise treadmill test
c. Stress echocardiogram
d. CT coronary angiogram
e. No further investigation

Correct Answer is E


This patient currently has a very low risk of coronary disease (<10%) and so no further ischaemic stratification is necessary. The cause of the symptoms appears to be related to the sinus tachycardia and energy drink. Aggressive primary prevention is, of course, paramount in view of the family history.