Question: A 31-year-old man who works for a moving company presents to the ED because he thinks he was having a heart attack. He does not smoke, and jogs 3 days a week. His father died of a heart attack in his sixties. He describes a gradual onset of chest pain that is worse with activity and resolves when he is at rest. His HR is 68 beats per minute, BP is 120/70 mm Hg, and RR is 14 breaths per minute. On examination, his lungs are clear and there is no cardiac murmur. You palpate tenderness over the left sternal border at the third and fourth ribs. An ECG reveals sinus rhythm at a rate of 65. A chest radiograph shows no infiltrates or pneumothorax. Which of the following is the most appropriate next step in management? A Administer aspirin and send for a troponin. B Administer aspirin, clopidogrel, and heparin, and admit for acute coronary syndrome (ACS). C Administer ibuprofen and reassure the patient that he is not having a heart attack. D Inject corticosteroid into the costochondral joint to reduce inflammation. E Observe the patient for 6 hours.
Posted on: Thu, 12 Sep 2013 09:06:18 +0000
Trending Topics
Recently Viewed Topics
© 2015