USMLE Step 2 - Question 19

A 86 year old female with a history of diabetes mellitus and hypertension presents to the emergency room with a complaint of chest pain x 4 hours. She has noted severe nausea with 2 episodes of emesis as well. She is now chest pain free. Her blood pressure is 130/70, heart rate 50,  respirations 20, and oxygen saturation 95% on room air. Physical examination reveals normal breath sounds and an S4 heart sound without murmurs. Her ECG is below.

Inferior-STEMI-4

Which of the following is the next appropriate step in management?

A. Sublingual nitroglycerine

B. Intravenous beta-blockers

C. Emergent cardiac catheterization

D. Glycoprotein IIb/IIIa inhibitor

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