Which statement is NOT part of the angina/potential myocardial infarction protocol described?

• A. Turn the nitrous oxide off and increase oxygen
• B. Administer aspirin
• C. Administer sublingual nitroglycerin
• D. Administer epinephrine

Answer: (D)

Managing chest pain suspected to be angina or a myocardial infarction in a dental setting focuses on stabilizing the patient by improving oxygen delivery, limiting thrombosis, and lowering the heart’s oxygen demand. Turning nitrous oxide off and giving high-flow oxygen ensures the heart muscle receives as much oxygen as possible. Administering aspirin rapidly helps inhibit platelet aggregation and can reduce thrombus formation in the coronary arteries. Giving sublingual nitroglycerin dilates coronary vessels, lowers preload and afterload, and often relieves pain if blood pressure allows. Administering epinephrine is not part of this immediate protocol because it doesn’t address the ischemia and can worsen myocardial oxygen demand and dysrhythmias; its appropriate use is for other emergencies like anaphylaxis or certain resuscitation scenarios. If symptoms continue or worsen, activating emergency medical services is essential.