A 55-year-old patient presents to the emergency department with severe chest pain, dyspnea, hypotension, and a rapid, thready pulse. The patient's medical history includes myocardial infarction one year ago. The ECG shows ST-segment elevation, and the chest X-ray does not indicate pneumothorax or hemothorax. Which intervention is MOST appropriate for managing this patient's condition?
High-concentration oxygen therapy alone
Administration of vasopressors without addressing revascularization
Aggressive volume expansion with intravenous fluids
Immediate revascularization is the most appropriate intervention for a patient presenting with signs and symptoms consistent with cardiogenic shock due to acute myocardial infarction (AMI). This involves percutaneous coronary intervention (PCI) or thrombolytic therapy, aimed at restoring blood flow to the affected myocardium, thereby improving cardiac output and reducing the severity of shock. Volume expansion may exacerbate pulmonary edema in cardiogenic shock and is not indicated without evidence of hypovolemia. Oxygen therapy and vasopressors are supportive treatments but do not address the underlying cause of cardiogenic shock in the context of AMI.
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