A 65-year-old man with known coronary artery disease on aspirin, nitroglycerin and a β-blocker has prolonged anginal chest pain for 3 days. ECG shows T-wave inversion. Cardiac enzymes are normal. What is the most important next step in management?
سؤال مجاني 2 من 10 اليوم · اشترك وكمّل بدون حد
اعرض الإجابة
الإجابة والشرح
ادخل لحسابك عشان نحفظ إجاباتك ونوريك أخطاءك.
الإجابة: B. Current medications + IV heparin
Prolonged rest angina with T-wave inversion and normal enzymes = unstable angina (NSTE-ACS). Besides antiplatelets, nitrates and β-blockers, management adds anticoagulation with heparin. Thrombolytics are not beneficial in UA/NSTEMI (STEMI only), digoxin has no role, and observation is unsafe.
ليش كل خيار صح أو غلط
-
B
ليش صح
Heparin is an anticoagulant that is beneficial in STEMI, NSTEMI and unstable angina, especially if the patient is going for cath. It is added to the antiplatelet therapy.
✓ (Y4)-(M B) Ischemic Heart and Acute coronary syndrome.pdf · p. 18 -
C
ليش غلط
Thrombolytics have not been shown to help in unstable angina or NSTEMI; they are indicated only in STEMI when urgent PCI is not available.
✓ Step-Up To Medicine 6th (IHD & ACS).pdf · p. 17 -
D
ليش غلط
Unstable angina belongs to the acute coronary syndromes, the most severe forms of ischemic heart disease, so it needs active treatment rather than observation alone.
✓ (Y4)-(M B) Ischemic Heart and Acute coronary syndrome.pdf · p. 8
- المصدر
- (Y4)-(M B) Ischemic Heart and Acute coronary syndrome.pdf · p. 18
Step-Up To Medicine 6th (IHD & ACS).pdf · p. 17 - المحاضرة
- Acute Coronary Syndrome · Cardiology · Module B
- ظهر في
- MED42 ♂ EOM B