Solved

A 34-Year-Old Man Is Brought to the Emergency Department with Central

question 13

Multiple Choice

A 34-year-old man is brought to the emergency department with central chest pain and nausea that started two hours ago. He looks anxious and admits to using cocaine before his chest pain started. He says that he uses cocaine once or twice per month, but has never had similar symptoms. He denies any past medical history and exercises regularly at a gym. He smokes cigarettes and drinks beer on the weekends. He has no family history of coronary artery disease or sudden death.
On physical examination, he is mildly diaphoretic. His blood pressure is 165/85 mm Hg and pulse is 105/min. His oxygen saturation is 98% on room air. Lungs are clear to auscultation. There are no murmurs. Peripheral pulses are brisk and symmetric.
ECG shows sinus tachycardia and a 2 mm ST segment elevation in leads II, III, and avF; a 1 mm ST segment depression is seen in lead I. Telemetry monitoring shows occasional premature ventricular beats. Portable chest X-ray is unremarkable.
He is immediately treated with sublingual nitroglycerin, aspirin, and benzodiazepines. Shortly thereafter, he reports improvement of his symptoms and now rates his chest pain as 3/10, down from the initial 8/10.
Which of the following is the best next step in managing this patient?

Definitions:

Movie Effect

The influence that watching movies or other multimedia content can have on a person's emotions, behavior, attitudes, or perceptions.

Eardrum Vibration

The movement of the eardrum in response to sound waves, crucial for the hearing process.

Sound Wave

A type of wave that is an oscillation of pressure transmitted through a solid, liquid, or gas, composed of frequencies within the range of hearing and capable of producing a sound sensation.

Pressure Wave

A type of wave in which the oscillations occur in the direction of propagation, often found in sound waves.