A 46-year-old smoker presents in an ED with a sharp ,left sided chest pain. The pain is not focal. On physical examination , there is no specific finding .Pain is neither aggravated nor relived with change of postural change and with inspiration. On an ECG , anterior ST elevation can be seen.What shall be the next step in management ?
As the patient comes with acute chest pain , and ECG shows anterior MI, pericarditis is ruled out . Ischemia must be urgently ruled out. When ECG is non diagnostic ,abnormalities of wall motion can be seen on echocardiography. It helps in aiding whether patient needs a fibrinolytic therapy or percutaneous coronary intervention ). It can't differentiate acute STEMI and old myocardial scar. It is a screening modality in emergency depament .
Activation of the primary angioplastyteam
Await troponin tests and give analgesia
Non-steroidal anti-inflammatory analgesia
Urgent bedside echo to rule out a regional wall motion abnormality
ECG and Arrhythmia 3