NSTEMI and Unstable Angina

Regarding the pathophysiology and management of NSTEMI and unstable angina, all of the following are true EXCEPT:

A 58-year-old man from Delhi presents with acute chest pain at rest for 2 hours, radiating to the left arm. His ECG shows ST-segment depression in leads II, III, aVF, and V4–V6 with T-wave inversion. Troponin I is elevated at 0.8 ng/mL (normal <0.04). Regarding the management of this NSTEMI, all of the following are appropriate EXCEPT:

A 58-year-old man with hypertension and dyslipidemia presents to the emergency department with chest pain of 3 hours duration. The pain is substernal, radiating to the left arm, and associated with diaphoresis. His initial ECG shows ST depression in leads II, III, aVF, and V3–V4 with T-wave inversion. Troponin I at presentation is negative. Vital signs are stable. What is the most appropriate immediate next step in management?

A 52-year-old woman with a history of smoking and diabetes mellitus presents with 2 episodes of severe substernal chest pain at rest over the past 24 hours. Each episode lasted 15 minutes and resolved with sublingual nitroglycerin. Her current ECG shows T-wave inversion in leads V2–V4. Troponin I is 0.08 ng/mL (upper limit of normal: 0.04 ng/mL). She is hemodynamically stable with no signs of heart failure. What is the most appropriate immediate next step?

A 62-year-old woman from Mumbai with a history of hypertension and smoking presents to the emergency department with 2 episodes of chest pain over the past 6 hours, each lasting 15–20 minutes and relieved by rest. The most recent episode occurred 30 minutes ago. She denies dyspnea or diaphoresis. Vital signs are stable: BP 135/88 mmHg, HR 78 bpm. Physical examination is unremarkable. 12-lead ECG shows T-wave inversion in leads V2–V4. Troponin I measured at presentation is <0.01 ng/mL (normal). Repeat troponin 3 hours later is also <0.01 ng/mL. What is the most likely diagnosis?