A Cardiac Conundrum

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Question 1 of 4

1. Question
What is the most likely diagnosis?
- Acute coronary syndrome
- Stable angina
- Pulmonary embolism
- Anxiety
- Musculoskeletal pain
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Question 2 of 4

2. Question
What is the most appropriate next step in this patient’s management plan?
- Refer to cardiology
- Discharge back to the care of the GP for ongoing management
- Initiate treatment for angina
- Discharge with analgesia and safety netting advice
- Use a risk assessment tool to estimate this patient’s probability of coronary artery disease
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Question 3 of 4

3. Question
What would be the most appropriate treatment for this lady if angina is suspected and the pre-test probability is high?
- Morphine, oxygen, nitrates, aspirin
- Glyceryl trinitrate (GTN) spray, aspirin, beta blocker, statin
- Prescribe GTN spray to see if it’s beneficial
- Await further testing before initiating treatment
- GTN, clopidogrel, ramipril
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Question 4 of 4

4. Question
If the patient experiences further chest pain during exertion what safety netting advice should be given?
- Administer GTN, call 999 immediately.
- Administer GTN, call 999 if pain persists after 5 minutes.
- Administer GTN, repeat the dose every 5 minutes, call 999 if pain persists for 10 minutes.
- Administer GTN, repeat the dose every 5 minutes, call 999 if pain persists for 15 minutes.
- Administer GTN, repeat the dose every 5 minutes, call 999 if pain persists for 20 minutes.
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A Cardiac Conundrum

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