Question

A 58-year-old with 30 minutes of crushing substernal chest pain arrives by EMS. Vitals are stable. What is the most time-critical first diagnostic step in the ED according to current guidelines?

Accepted Answer

Obtain and interpret a 12-lead ECG within 10 minutes of arrival

Answer

Draw high-sensitivity troponin and repeat at 3 hours

Answer

Obtain a chest radiograph before ECG

Answer

Order CT coronary angiography

Answer

Administer aspirin and defer ECG until after labs

Practice question

A 58-year-old with 30 minutes of crushing substernal chest pain arrives by EMS. Vitals are stable. What is the most time-critical first diagnostic step in the ED according to current guidelines?