A 72-year-old woman presents to the hospital with oppressive chest pain of 2 hours' duration. Blood pressure is 68/32 mm Hg, heart rate is 124 beats/min, respiratory rate is 32 breaths/min, oxygen saturation is 91% with oxygen at 50%, bilateral crackles on pulmonary auscultation. An ECG shows a subepicardial lesion in the anterior face, with a specular image in the inferior face. Chest X-ray shows bilateral alveolar pattern. What is your therapeutic decision?
Perform urgent coronary angiography.
Start i.v. nitrate infusion.
Perform fibrinolysis with tenecteplase (TNK).
Perform urgent coronary angioplasty.
Administer furosemide 40 mg i.v.
Perform urgent coronary angiography.