Sudden Severe Central Chest in Medicine / Internal Medicine — 60yo Man | Cardiology | SMLE Q#11686

SMLE Question #11686

Medicine / Internal Medicine Cardiology

Objective: OBJ-163

Last updated: February 2026
A 60-year-old man presents 4 days after open cholecystectomy with sudden severe central chest pain radiating to the left arm, with diaphoresis and nausea. ECG shows 3 mm ST-segment elevation in leads II, III, and aVF with reciprocal ST depression in V1–V3. He received oxygen, IV morphine, chewable aspirin, and sublingual nitroglycerin with partial relief. He is in a PCI-capable hospital with an interventional team available within 30 minutes. What is the most appropriate next step in management?

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