Chest Pain: Who Needs Additional Testing Beyond ECG and Troponin?

In the first case, we describe a 45-year-old man who presented to the emergency department for evaluation of chest pain. He reported having chest discomfort 5 days prior that lasted a few minutes after an altercation with his coworker. In the second case, we describe a 54-year-old woman with history of well-controlled diabetes mellitus, hypertension, and dyslipidemia who presented to the ED with a 10-day history of intermittent sharp and burning chest pain in the substernal region, 5/10 intensity, lasting 15-20 minutes, associated with exertion. (Level of Difficulty: Intermediate.)