🏥 USMLE Exam Prep

A 68-year-old male presents with retrosternal chest pain radiating to his left arm, worsening over the last hour. ECG shows ST depressions in leads V4-V6. Troponin I is elevated. He is currently on aspirin and clopidogrel at home. His blood pressure is 140/90 mmHg. What is the most appropriate initial pharmacological agent to administer in the emergency department, assuming no contraindications?

A Intravenous furosemide
B Oral metoprolol
C Sublingual nitroglycerin
D Intravenous morphine

✓ Correct Answer: Option C

For acute coronary syndromes, sublingual nitroglycerin is a first-line agent to reduce chest pain by causing vasodilation, decreasing myocardial oxygen demand, and improving coronary blood flow. It should be given immediately if not contraindicated.

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