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A 64-Year-Old Man Comes to the Emergency Department with Sharp

question 1425

Multiple Choice

A 64-year-old man comes to the emergency department with sharp, left-sided chest pain for the last 24 hours. The pain is worsened by deep breathing and relieved with leaning forward. He also complains of decreased appetite, fatigue, and occasional nausea over the last several weeks. He suffered an acute non-ST-elevation myocardial infarction 1 year ago and had stent placement in the right coronary artery. His other medical problems include type 2 diabetes mellitus complicated by retinopathy and peripheral neuropathy, hypertension, hyperlipidemia, hypothyroidism, and chronic kidney disease. His temperature is 36.1° C (97° F) , blood pressure is 142/86 mm Hg, pulse is 98/min, and respirations are 16/min. A friction rub is heard at the left lower sternal border. Electrocardiogram shows normal sinus rhythm with asymmetric T-wave inversion in leads V5 and V6. Laboratory results are as follows: Which of the following is the most appropriate therapy for this patient's chest pain?

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