New chest tightness on the hills — CCE clinical encounter

Objectives

1. Classify the pain using the three-feature taxonomy and set pre-test probability. ^[7]
2. Order the first-line investigation appropriately — CT coronary angiography — without over- or under-investigating. ^{[9] [8]}
3. Initiate optimal medical therapy: anti-anginal plus secondary prevention. ^[11]
4. Refer to cardiac rehabilitation and address smoking as the modifiable driver. ^[14]
5. Safety-net instability explicitly — rest pain, crescendo, GTN failure → ambulance. ^[7]