Subjective
58-year-old with central chest tightness for two hours, worse on exertion. No previous cardiac history (no source).
Objective
Sinus rhythm at 78 bpm without ST changes; high-sensitivity troponin 18 then 21 ng/L, below the 99th percentile.
Assessment
Low risk of acute myocardial infarction on the 0/3-hour pathway; stable angina remains possible.
Plan
Outpatient exercise testing. Return if pain comes on at rest (no source).
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