What is the best initial therapy for managing a patient with chest pain?

Oxygen administration and obtaining a 12-lead ECG represent the best initial therapy for managing a patient with chest pain. The rationale behind this approach is twofold. First, administering oxygen helps to improve oxygen delivery to the heart and other vital organs, especially if the patient is experiencing hypoxia. Maintaining adequate oxygen saturation levels is crucial in patients with potential cardiac events.

Second, obtaining a 12-lead ECG is essential for diagnosing the underlying cause of chest pain. The ECG provides critical information regarding the electrical activity of the heart and can be instrumental in identifying serious conditions such as ST-elevation myocardial infarction (STEMI) or other arrhythmias. This diagnostic tool allows healthcare providers to assess the nature of the chest pain and to determine the most appropriate treatment interventions based on the findings.

In contrast, while administering nitroglycerin can relieve chest pain by dilating coronary arteries, it may not be appropriate for all patients, especially those with specific contraindications or unknown medical histories. Additionally, performing CPR is reserved for patients who are unresponsive or are in cardiac arrest, not for those merely presenting with chest pain. Providing aspirin can be beneficial as a part of treatment for suspected myocardial infarction, but it should ideally follow the initial assessment and