Facharzt FMH Allgemeine Innere Medizin Practice Questions - Facharzt FMH Für Allgemeine Innere Medizin Spécialiste FMH En Médecine Interne Générale Exam

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A 58-year-old female presents to the emergency department with 45 minutes of crushing substernal chest pain. The ECG shows 2.5 mm ST-segment elevations in leads II, III, and aVF with reciprocal ST depressions in I and aVL. Blood pressure is 88/54 mmHg, heart rate is 52 bpm, and clear lung fields are noted on auscultation. What is the most appropriate next step in management?

Right-sided precordial ECG (leads V3R-V4R) and urgent primary percutaneous coronary intervention (PCI) Immediate intravenous nitroglycerin infusion and high-dose beta-blocker Immediate intravenous administration of 500 mg methylprednisolone Transesophageal echocardiography prior to coronary angiography

Correct Answer:

Right-sided precordial ECG (leads V3R-V4R) and urgent primary percutaneous coronary intervention (PCI)

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