Q98) A 68 year old man with history of DM type II, Hypertension and severe osteoarthritis presents to your office with complaints of chest pain on exertion for past 3 months. He denies any pain now. His only medications are Glyburide, Metprolol, Enalapril and Metformin. An EKG is obtained in the office and it reveals non-specific ST segment changes. While undergoing the test, the patient develops severe chest pain and headache. EKG monitor reveals > 2mm ST depressions in the anterior leads. The technician immediately terminates the dipyridamole infusion. After 2 minutes of cessation of infusion, the patient continues to have chest pain. His blood pressure is 88/68 mm hg. The next step in managing this patient :
A) Order Cardiac enzymes
B) Start Heparin infusion
C) Administer Intravenos Aminophylline
D) Reassure the patient that symptoms will improve in few minutes
E) Urgent Cardiac Catheterization
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Archer USMLE Step 3 Blog 
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