USMLE Step 3 - Question 38

A 86 year old female with a history of diabetes mellitus and hypertension presents to the emergency room with a complaint of chest pain for 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. 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