AOBIM Internal Medicine Practice Questions - AOBIM Internal Medicine Certifying Examination Exam

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A 62-year-old man presents with retrosternal chest pain at rest for 30 minutes, diaphoresis, and dyspnea. ECG shows 3-mm ST elevation in V2-V4. Initial troponin elevated. He is 60 minutes from a PCI-capable center. What is the most appropriate management?

Administer aspirin 162-325 mg chewed, heparin, and transfer for primary PCI (door-to-balloon goal ≤90 minutes) Give thrombolytics (tenecteplase) only if PCI is unavailable within 120 minutes Wait for cardiology consultation before any intervention Administer beta-blocker as first-line therapy

Correct Answer:

Administer aspirin 162-325 mg chewed, heparin, and transfer for primary PCI (door-to-balloon goal ≤90 minutes)

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