Correct!
5. All of the above

His chest x-ray was read as unremarkable consistent with his recent CABG. ECG showed normal sinus rhythm, right bundle branch block, and diffuse ST-segment elevation. However, the ECG was unchanged from hospital discharge. Troponins were elevated at 0.20 ng/mL (normal <0.01 ng/mL).

He was transferred to the intensive care unit at the Mayo Clinic in Rochester. On admission his vital signs were:

• Pulse 105 beats/min
• BP 107/65 mm Hg
• Respirations 20 breaths/min
• SpO2 90% on 2L/min by nasal cannula

His physical examination was unremarkable. However, shortly after admission his blood pressure decreased to 84/52 mm Hg.

Which of the following is appropriate at this time? (Click on the correct answer to proceed to the third of four panels)

1. Administer crystalloids for hypotension
2. Administer tissue plasminogen activator (tPA)
3. Perform a bedside echocardiogram
4. 1 and 3
5. All of the above

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