Question

A 62 year-old male presents with crushing chest pain, which he describes as being the same kind of pain that he had with a previous heart attack. He has prescribed nitroglycerin, but states he has not taken any. After administering 100% oxygen and contacting medical control you should:

A) Begin immediate transport and request rendezvous with a paramedic unit.
B) Assist him with his nitroglycerin unless his systolic BP is less than 100 mm HG
C) Administer up to three doses of nitroglycerin before assessing his blood pressure
D) Administer the nitroglycerin unless he has taken Viagra within the past 72 hours

Answer 1

Assist the 62-year-old male with his prescribed nitroglycerin if his systolic blood pressure is above 100 mmHg and he has not taken Viagra in past 72 hours, as it relieves angina by dilating coronary arteries.

Step-by-step explanation:

A 62-year-old male with a history of a heart attack presents with crushing chest pain. After administering 100% oxygen and contacting medical control, the correct course of action would be to assist him with his nitroglycerin unless his systolic blood pressure is less than 100 mmHg. This treatment is contingent on confirming that the patient has not taken phosphodiesterase inhibitors like Viagra in the past 72 hours, as there is a potential for severe hypotension when these are combined with nitroglycerin.

Nitroglycerin works by releasing nitric oxide, which is a vasodilator that relaxes the smooth muscle in the coronary vessels, therefore improving blood flow and oxygen supply to the heart muscle. Understanding the difference between stable angina and unstable angina is key in this scenario; the latter, characterized by pain at rest or a new onset of severe pain, signifies a higher risk for myocardial infarction and requires immediate medical attention.