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A 70-year-old man is brought to the emergency department with complaints of chest pain for the
last 2 hours. He had been discharged from the hospital 10 days ago after an acute myocardial
infarction and percutaneous coronary intervention. The patient prefers to hunch forward during
the physical exam because it decreases his chest pain. He says the pain is in the
middle of his
chest and radiates to his back. Despite looking unwell, the patient denies palpitations or
shortness of breath. Vital signs are temperature 36.8°C (98.2°F), heart rate 90/min, respiratory
rate 20/min, and blood pressure 134/82 mm Hg. The patient is visibly distressed and is taking
shallow breaths because deeper breaths worsen his chest pain. An ECG shows diffuse ST
elevations. Troponin I levels are normal on serial testing. A chest- X-ray shows no infiltrates or
effusions. Which of the following should be administered to this patient?
OA. Clopidogrel
B. Ibuprofen
OC. Heparin
D. Levofloxacin
E. Propranolol
OF. Warfarin

Sagot :

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