Coronary Artery Disease - STEMI Case #5 - Question #1

A 58-year-old asthmatic female with a history of hypertension, type 2 diabetes and a prior stroke presents to the ED with substernal chest pains radiating to her left arm. She is short of breath, diaphoretic and nauseated. She is afebrile with a blood pressure of 150/90 mm Hg, heart rate of 90 beats per minute, respirations 22 per minute and oxygen 92% on room air. Physical examination reveals an S4 heart sound and significant wheezing on lung examination. Her ECG is below:

inferior-posteriorSTEMI2

Which of the following combinations of initial medical therapy is appropriate?

A. Aspirin, clopidogrel, unfractionated heparin, beta-blocker, oxygen, nitroglycerin

B. Aspirin, prasugrel, low molecular weight heparin, non-dihydropyridine calcium channel blocker, oxygen, nitroglycerin

C. Aspirin, clopidogrel, low molecular weight heparin, non-dihydropyridine calcium channel blocker, oxygen, nitroglycerin

D. Aspirin, prasugrel, unfractionated heparin, beta-blocker, oxygen, nitroglycerin

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