A 48-year-old male is sitting upright in bed in respiratory distress. He describes an acute onset of difficulty breathing and chest pain during the night that has been worsening for the past 3 hours. He also complains of nausea. Pain is described as a substernal pressure radiating to his left shoulder. Physical examination reveals cool, diaphoretic skin and rales on auscultation bilaterally. Medical history includes two prior myocardial infarctions. Medications include Zestril and metoprolol. HR = 132, BP = 140/100, RR = 25, SaO2 = 92%. Which of the following is NOT indicated?
A) Adenosine
B) Enalapril
C) Morphine
D) Nitroglycerin
A
Health Professions
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