22.A 59-year-old man presents to the ED with left-sided chest pain and short-
ness of breath that began 1 hour ago. Initial vital signs are BP 85/45 mm Hg,
HR 105 beats per minute, RR 20 breaths per minute, and oxygen saturation
94% on room air. An ECG is seen below. Which of the following is the most
appropriate definitive treatment?
Chest Pain and Cardiac Dysrhythmias 13a. Administer metoprolol or diltiazem
b. Electrical cardioversion
c. Administer calcium gluconate
d. Thrombolytic therapy
e. Percutaneous angioplasty
23.A 55-year-old man presents to the ED at 2:00 AMwith left-sided chest
pain that radiates down his left arm. He takes a β-blocker for hypertension,
a proton-pump inhibitor for gastroesophageal reflux disease, and an
antilipid agent for high cholesterol. He also took sildenafil the previous
night for erectile dysfunction. His BP is 130/70 mm Hg and HR is 77 beats
per minute. Which of the following medication is contraindicated in this
patient?
a. Aspirin
b. Unfractionated heparin
c. Nitroglycerin
d. Metoprolol
e. Morphine sulfate