12-17-2008, 04:11 PM
A 74-year-old man is evaluated in the emergency department for lightheadedness, near syncope, chest pressure, and diaphoresis. He has a long-term history of atrial fibrillation and had coronary artery bypass graft surgery 2 years ago. His medications are warfarin and nitroglycerin.
In the emergency department, electrocardiogram shows an irregular rhythm with anterior ST-segment elevation and frequent premature ectopic beats. He is given heparin and undergoes immediate coronary angiography, which reveals distal diffuse disease, elevated left ventricular end-diastolic pressure, and akinesis of the apical anterior wall with a mildly reduced ejection fraction. Medical therapy is begun. After 3 days in the hospital, he develops facial flushing and hives after receiving aspirin 325 mg orally. His discharge medications include metoprolol, isosorbide dinitrate, captopril, warfarin, and a statin.
What additional medical therapy is indicated?
A Dipyridamole
B Clopidogrel
C Low-molecular-weight heparin
D Glycoprotein receptor blocker
In the emergency department, electrocardiogram shows an irregular rhythm with anterior ST-segment elevation and frequent premature ectopic beats. He is given heparin and undergoes immediate coronary angiography, which reveals distal diffuse disease, elevated left ventricular end-diastolic pressure, and akinesis of the apical anterior wall with a mildly reduced ejection fraction. Medical therapy is begun. After 3 days in the hospital, he develops facial flushing and hives after receiving aspirin 325 mg orally. His discharge medications include metoprolol, isosorbide dinitrate, captopril, warfarin, and a statin.
What additional medical therapy is indicated?
A Dipyridamole
B Clopidogrel
C Low-molecular-weight heparin
D Glycoprotein receptor blocker