Problem:
A 75-year-old male presents to an ambulatory care clinic with new-onset chest pain that started 1 hour ago. His past medical history includes coronary artery disease, hypertension, and diabetes mellitus type 2. He is a current smoker. His medications include aspirin, atenolol, simvastatin, and metformin. On physical examination, the patient's temperature is 36.9°C (98.4°F), pulse rate is 91/min, blood pressure is 131/71 mmHg, and respiration rate is 22/min. Cardiac and pulmonary physical exam findings are normal. His initial electrocardiogram is shown below, and labs are pending. Which of the following is the most appropriate next step? A. Obtain computed tomographic angiography B. Activate emergency response C. Admit for chest pain observation D. Repeat electrocardiogram in 10 minutes