Advanced Cardiovascular Life Support (ACLS) Practice Exam

A 49-year-old woman presents with persistent epigastric pain after taking oral antacids. What is the most appropriate intervention next?

1. Initiate intravenous fluids

2. Administer pain medication

3. Obtain a 12 lead ECG

4. Perform a physical examination

The correct answer is: Obtain a 12 lead ECG

In the context of a 49-year-old woman presenting with persistent epigastric pain, obtaining a 12-lead ECG is a critical step in the management process. While epigastric pain can often be attributed to gastrointestinal issues such as gastritis or peptic ulcer disease, it can also be indicative of cardiac-related conditions, particularly in women who may present with atypical symptoms of myocardial ischemia or infarction. Therefore, performing a 12-lead ECG allows for the assessment of the electrical activity of the heart and helps to identify any ischemic changes or arrhythmias that may necessitate immediate intervention. This is crucial given the potential for life-threatening cardiac events, especially in a middle-aged female patient, where the risk factors for coronary artery disease may be present. While initiating intravenous fluids, administering pain medication, and conducting a physical examination are important aspects of patient management, they do not directly address the possibility of a cardiac event as urgently and effectively as obtaining an ECG does. The ECG provides essential information that can guide further treatment decisions based on the cardiac status of the patient.