Coronary Artery Disease - Unstable Angina/Non-STEMI Case #1

A 58-year-old female presents with chest pains. She has had no recent bleeding or trauma and has no history of stroke. She is afebrile with a heart rate of 70 beats per minute, blood pressure 140/90 mm Hg and respirations 20 per minute. Her ECG is below:


She is given aspirin, clopidogrel, metoprolol and unfractionated heparin. Nitrates have completely relieved her chest pains. Her troponin measured 15. Which of the following is an appropriate treatment strategy?

A. Thrombolytic therapy

B. Initial conservative therapy with medical management

C. Early invasive angiography