Best of Five 3.119

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BOF: 3.119

A 42-year-old man presents severe crushing retrosternal chest pain radiating to his left arm and into his neck. There is no significant past illnesses but he admitted to snorting cocaine prior to the onset of the pain.

On examination you note the patient’s skin is cold and clammy , his pulse rate is 110 beats per minute , BP 100/60 JVP not elevated , heart sounds normal no murmurs , lungs are clear.

ECG shows ST segment elevation in the anterior chest leads.

In this patient which one of the following methods of treatment would you institute?

a)      Percutaneous coronary intervention

b)      Thrombolysis

c)      Beta blockade

d)     Low molecular weight heparin

e)      Glycoprotein IIb/IIIa inhibition

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