A 90-year-old man presented with acute chest discomfort and SOB. He is a heavy smoker with a history of recurrent admissions for COPD exacerbations. His BP was 120/80 mmHg and SpO2 was 88% on room air.
Which of the following is the most appropriate next step in management?
Choose the correct answer.
The ECG showed an RBBB with ST elevation in leads V1–V4, consistent with an anterior STEMI.
Patients with COPD and cor pulmonale—without acute myocardial infarction—should not exhibit ST elevation on the ECG. RV dilation in COPD patients can be attributed to cor pulmonale alone, even in the absence of a pulmonary embolism. A prolonged QTc without torsades de pointes does not warrant IV magnesium treatment
