Question 1

Question

A 68-year-old man with a history of hypertension and type 2 diabetes presents to the emergency department with 2 hours of crushing substernal chest pain radiating to his left arm, diaphoresis, and nausea. BP is 88/60 mmHg, HR is 112 bpm, RR is 22/min, and SpO₂ is 94% on room air. The ECG shows ST elevations in leads II, III, and aVF with reciprocal ST depressions in leads I and aVL, consistent with an acute inferior STEMI. Crackles are heard at both lung bases. The nearest cardiac catheterization laboratory is 3 hours away by transport. Which of the following is the most appropriate immediate reperfusion strategy?

Accepted Answer

Administer IV fibrinolytic therapy with tenecteplase followed by transfer to a PCI-capable facility

Answer

Arrange emergent transfer to the nearest PCI-capable facility

Answer

Initiate IV heparin infusion and obtain urgent echocardiography

Answer

Administer IV metoprolol to reduce myocardial oxygen demand

Answer

Begin IV dobutamine infusion and reassess hemodynamics in 30 minutes

Heart failure — MCQs

Heart failure — MCQs

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