In the assessment of a patient with chest pain suggestive of myocardial infarction, which action should be taken first if not contraindicated?

• A. Obtain an ECG
• B. Administer aspirin now
• C. Call for help
• D. Prepare for emergent surgery

Answer: (B)

Early administration of aspirin is a priority in suspected myocardial infarction. Aspirin quickly inhibits platelet aggregation by irreversibly blocking COX-1, which reduces thromboxane A2 and helps prevent the growth of the clot that’s blocking blood flow. This antiplatelet effect occurs rapidly and aspirin is inexpensive, widely available, and safe for most patients with chest pain unless there’s a true contraindication (like active GI bleed or aspirin allergy). Because of its potential to improve outcomes right away, giving aspirin now is the most impactful first action while other urgent steps—such as obtaining an ECG to confirm the diagnosis and activating emergency care—are carried out. Preparing for emergent surgery is not the immediate step in this scenario.