Question

A patient with an acute Ml on a 12-lead ECG transmitted by the paramedics has the above findings on a rhythm strip when a monitor is placed in the ED. The patient had resolution of moderate (5/10) chest pain with three doses of sublingual nitroglycerin. Blood pressure is 104/70 mmHg. Which intervention below is most important, reducing in-hospital and 30-day mortality?

A. Atropine 1 mg IV, total dose 3 mg as needed
B. Intravenous nitroglycerin for 24 hours
C. Reperfusion therapy
D. Atropine 0.5 mg IV, total dose 2 mg as needed
E. Temporary pacing

Answer 1

Reperfusion therapy is the most important intervention for reducing mortality in a patient with an acute Myocardial Infarction, as it restores blood flow to the heart muscle and can significantly salvage the myocardium.

Step-by-step explanation:

The most important intervention for reducing in-hospital and 30-day mortality in a patient with an acute Myocardial Infarction (MI) is Reperfusion therapy. Immediate treatments for an MI include administering supplemental oxygen, aspirin to help break up clots, and nitroglycerine sublingually.

However, these are initial treatments, and the crucial step for long-term benefit is restoring the blood flow to the affected area of the heart as soon as possible through reperfusion therapy. This can be done by thrombolytic agents such as streptokinase, which dissolve the clot, percutaneous coronary intervention (PCI) with balloon angioplasty and stents, or coronary artery bypass surgery (CABG). These reperfusion strategies are critically important to salvage heart muscle and reduce mortality.