MEDT 600, Cardiovascular
A man has had crushing chest pain radiating to the left arm for 6 hours. His ECG shows ST elevation in leads II, III and aVF. What is the most appropriate next step?
ST elevation in II, III and aVF is an inferior STEMI. Within 12 hours of onset, give aspirin and reperfuse: primary PCI where it's available, otherwise thrombolysis. Nitrates relieve pain but don't reopen the artery, and IV beta blockers and digoxin have no place first.