Rosh Emergency Medicine Practice Test

Which treatment option has been shown to reduce mortality in patients with suspected acute myocardial infarction?

1. Aspirin

2. Morphine

3. Nitroglycerin

4. Oxygen

The correct answer is: Aspirin

Aspirin is well-recognized for its role in the management of acute myocardial infarction (MI). Its primary mechanism involves the inhibition of platelet aggregation, which is crucial following an acute coronary event when a thrombus (clot) forms at the site of plaque rupture. By preventing further clot formation, aspirin helps restore blood flow to the heart muscle, thereby reducing myocardial damage and associated mortality. The evidence supporting the use of aspirin in this context is substantial. Clinical trials have consistently demonstrated that early administration of aspirin during an acute MI significantly decreases the risk of death, reinfarction, and the need for urgent revascularization procedures. Therefore, its role as a first-line agent in the acute treatment of suspected MI is firmly established in guidelines. While other treatments like morphine, nitroglycerin, and supplemental oxygen may offer symptomatic relief or address specific complications, their direct impact on reducing mortality in the setting of acute MI is not as well-supported by evidence. For example, morphine can effectively relieve pain and anxiety, but its effects on mortality are less clear and may even complicate clinical management. Nitroglycerin is primarily used for chest pain relief and to reduce myocardial oxygen demand; however, its role in mortality reduction is not established