What is the most appropriate next step in a patient presenting with chest pain and risk factors suggestive of acute coronary syndrome?

In a patient presenting with chest pain who has risk factors indicative of acute coronary syndrome (ACS), measuring Troponin I is the most appropriate next step. Troponins are proteins released into the bloodstream when there is damage to the heart muscle, making them highly sensitive and specific biomarkers for myocardial injury.

In the context of ACS, the assessment of Troponin levels is critical for diagnosis. Elevated levels indicate that the heart has been under stress or has sustained injury, which can help determine the underlying cause of the chest pain and guide management decisions. An early Troponin test allows for timely intervention, which is vital in preventing complications associated with ACS.

Other procedures, such as an echocardiogram, stress test, or aortogram, while valuable in certain contexts, are not immediate priorities in the acute setting. An echocardiogram may provide information about heart function and structural abnormalities, but it does not directly address the need for identifying myocardial injury in the acute phase. A stress test has a role in assessing functional capacity and prognosis in stable patients but is not appropriate during an active presentation of chest pain. An aortogram is used to evaluate for aortic dissection or aneurysm and would not be the next step in this specific clinical