Chest Pain in an Active Duty Soldier
A 44-year-old active duty special operations male soldier presents with recurrent substernal chest pressure and exercise intolerance preceded by a two-week febrile, non-bloody diarrheal illness while deployed to Guatemala. Physical examination is grossly normal. Electrocardiogram demonstrates a normal sinus rhythm, diffuse ST depressions with deep T wave inversions and ST elevation in lead aVR. Laboratory evaluation reveals a troponin I of 17.3 ng/mL, an elevated c-reactive protein (CRP), and an elevated erythrocyte sedimentation rate (ESR). The patient is admitted and treated for presumed non-ST elevation myocardial infarction and receives standard medical pharmacotherapies. Invasive coronary angiography reveals no significant coronary artery disease. Echocardiogram shows a preserved ejection fraction without any wall motion abnormalities or valvular lesions. Cardiac magnetic resonance (CMR) imaging performed is shown in Figure 1.
Which of the following is most appropriate regarding the next best step in management for this soldier?