What are the goals in response to angina pectoris: possible myocardial infarction?

• A. Calm the patient.
• B. Get the patient to breathe as much pure oxygen as possible.
• C. Administer sublingual nitroglycerin, baby aspirin, and morphine or fentanyl if tolerated.
• D. Assist the patient and the dentist until emergency personnel arrive.

Answer: (C)

In suspected angina with possible myocardial infarction, the priority is to relieve ischemia, limit heart damage, and address the clotting process. Administering sublingual nitroglycerin is key because it rapidly dilates coronary vessels and lowers the heart’s workload, which can relieve chest pain and reduce oxygen demand. Giving chewable aspirin promptly helps prevent further platelet aggregation and thrombus growth on a ruptured plaque, a central mechanism in MI. If pain persists and there are no contraindications, morphine or fentanyl provides effective analgesia and helps reduce sympathetic drive that can worsen oxygen demand. Oxygen therapy is not automatically given to everyone; it’s reserved for patients who are hypoxic or in distress, since unnecessary oxygen can have downsides. While calming the patient and arranging emergency help are important, the most effective immediate steps address pain relief, ischemia management, and clot control with these medications.