Question

A 64-year-old man presents to the emergency department with central crushing chest pain for 90 minutes radiating to his left arm. He is diaphoretic and nauseated. ECG shows ST elevation in leads II, III and aVF. His blood pressure is 132 over 78 mmHg. What is the single most appropriate next step in his acute management

Accepted Answer

Give 300 mg Aspirin and arrange immediate primary percutaneous coronary intervention

Answer

Give subcutaneous low-molecular-weight Heparin and discharge with early outpatient review

Answer

Start Clopidogrel monotherapy and arrange exercise tolerance testing

Answer

Give oral Atenolol and admit for routine cardiology review

Answer

Arrange thrombolysis in 24 hours if pain persists

Practice question