Heart Failure IV

Cardiovascular System


{"ops":[{"insert":"A 66-year-old man is brought to the emergency department because of a 2-hour history of crushing substernal chest pain radiating to the left shoulder. His pulse is 100\/min and blood pressure is 85\/50 mmHg. Pulse oximetry on room air shows an oxygen saturation of 92%. His peripheries are cold. An ECG shows deep symmetric T-wave inversion in the lateral leads. Which of the following is the most appropriate next step in management?\n"}]}

Background

{"ops":[{"insert":"\n"}]}

(A)

Anticoagulation
{"ops":[{"insert":"\n"}]}

(B)

Thrombolysis
{"ops":[{"insert":"\n"}]}

(C)

Inotropes
{"ops":[{"insert":"\n"}]}

(D)

Diuretics
{"ops":[{"insert":"\n"}]}

(E)

Percutaneous coronary intervention
{"ops":[{"insert":"\n"}]}

References

{"ops":[{"insert":"UNVERZAGT S, WACHSMUTH L, HIRSCH K, THIELE H, BUERKE M, HAERTING J, WERDAN K, PRONDZINSKY R. Inotropic agents and vasodilator strategies for acute myocardial infarction complicated by cardiogenic shock or low cardiac output syndrome. Cochrane Database Syst Rev [online] 2014 Jan 2:CD009669 [viewed 27 May 2019] Available from: http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/24385385"},{"insert":"\n","attributes":{"list":"ordered"}},{"insert":"ROFFI M, PATRONO C, COLLET JP, MUELLER C, VALGIMIGLI M, ANDREOTTI F, BAX JJ, BORGER MA, BROTONS C, CHEW DP, GENCER B, HASENFUSS G, KJELDSEN K, LANCELLOTTI P, LANDMESSER U, MEHILLI J, MUKHERJEE D, STOREY RF, WINDECKER S, ESC SCIENTIFIC DOCUMENT GROUP .. 2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: Task Force for the Management of Acute Coronary Syndromes in Patients Presenting without Persistent ST-Segment Elevation of the European Society of Cardiology (ESC). Eur Heart J [online] 2016 Jan 14, 37(3):267-315 [viewed 27 May 2019] Available from: http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/26320110"},{"insert":"\n","attributes":{"list":"ordered"}}]}

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