A 52-year-old patient presents to the emergency department with chest pain that started while mowing the lawn. The pain is substernal, radiates to the left arm, and is described as a pressure sensation. The patient appears diaphoretic and reports nausea. The initial 12-lead ECG shows ST-segment elevation in leads II, III, and aVF. Which of the following is the MOST appropriate next step in management?
The patient's presentation is highly suggestive of an ST-segment elevation myocardial infarction (STEMi), particularly involving the right coronary artery as indicated by ST-segment elevation in leads II, III, and aVF which represent the inferior region of the heart. The most appropriate next step is to prepare for urgent reperfusion therapy, which can be achieved through percutaneous coronary intervention (PCI) or thrombolytic therapy. Administering aspirin and sublingual nitroglycerin are important initial treatments, but the priority is to restore blood flow to the affected myocardium. A cardiology consultation is necessary but does not take precedence over initiating reperfusion therapy.
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