🏥 USMLE Exam Prep

A 55-year-old male presents to the ED with 3 hours of substernal chest pain radiating to his left arm. ECG shows ST-segment elevations in leads II, III, and aVF. Cardiac troponin I is elevated. He has no contraindications to thrombolysis. What is the most appropriate next step in management after initial stabilization and aspirin administration?

A Initiate unfractionated heparin infusion.
B Prepare for immediate percutaneous coronary intervention (PCI).
C Administer intravenous nitroglycerin.
D Order a stat echocardiogram.

✓ Correct Answer: Option B

For STEMI, immediate reperfusion is critical. PCI is the preferred reperfusion strategy over thrombolysis if it can be performed within recommended timeframes, offering superior outcomes by directly opening the occluded artery.

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