A 16-year-old girl with intermittent sharp chest pain needs which of the following as the next best step in management?

In the case of a 16-year-old girl experiencing intermittent sharp chest pain, the most appropriate next step in management is reassurance. This demographic often presents with non-cardiac related chest pain, which can frequently be attributed to musculoskeletal issues, anxiety, or other benign causes.

Given that the patient is young, has no established cardiac history, and the nature of the pain is intermittent and sharp, it is reasonable to conclude that the pain is not immediately concerning from a cardiac standpoint. Reassurance can be effective in alleviating anxiety and may prevent unnecessary medical interventions.

While options like a cardiac stress test or referral to a cardiologist could be considered if there were signs or symptoms of more serious conditions (such as syncope, significant family history of heart disease, or abnormal findings on a physical examination), in this scenario, the typical presentation of chest pain in a young adolescent leans towards benign causes.

A chest x-ray might be ordered in cases where there is a suspicion of underlying lung issues or structural abnormalities but is not the first approach here, especially when reassurance can effectively address the concern at this stage. Thus, concluding the management approach with reassurance is the best and most appropriate initial step.