Patient reports recurring chest pain radiating to left arm, onset during physical activity. Episodes lasting 5-10 min. Denies shortness of breath at rest.

BP: 145/92 mmHg · HR: 88 bpm · SpO2: 97% ECG: ST depression in leads V4-V6 Heart sounds: Regular, no murmurs

Unstable angina pectoris. Elevated blood pressure. Rule out acute coronary syndrome.

1. Order Troponin levels stat 2. Continue Aspirin 81mg daily 3. Start Metoprolol 25mg BID 4. Cardiac stress test within 48h 5. Follow-up in 1 week