A 62-year-old man arrives as ESI 2 with crushing chest pain, diaphoresis, BP 86/54, HR 48, RR 22, SpO2 94%. ECG shows ST elevation in II, III, and

Question

A 62-year-old man arrives as ESI 2 with crushing chest pain, diaphoresis, BP 86/54, HR 48, RR 22, SpO2 94%. ECG shows ST elevation in II, III, and aVF with ST elevation in V4R. Lungs are clear and he has jugular venous distention. Which of the following is the most appropriate initial action?

Accepted Answer

Give isotonic IV fluids and activate the catheterization laboratory

Answer

Give IV beta-blocker therapy and observe serial ECGs

Answer

Order CT angiography of the chest before reperfusion

Answer

Start IV furosemide and noninvasive ventilation

Answer

Administer sublingual nitroglycerin and start morphine

Right ventricular myocardial infarction — ABEM Board MCQ

A 62-year-old man arrives as ESI 2 with crushing chest pain, diaphoresis, BP 86/54, HR 48, RR 22, SpO2 94%. ECG shows ST elevation in II, III, and aVF with ST elevation in V4R. Lungs are clear and he has jugular venous distention. Which of the following is the most appropriate initial action?