What is the first step in managing a patient with suspected myocardial infarction?

In cases of suspected myocardial infarction, the first priority is to assess the patient's heart activity and identify any abnormalities. Obtaining a 12-lead ECG is crucial because it provides critical information regarding the heart's electrical activity, allowing healthcare providers to confirm the presence of a myocardial infarction and determine its type and extent. This information is vital for directing further management and treatment, such as deciding whether to initiate medical therapy, perform interventions like angioplasty, or administer specific medications.

Establishing a definitive diagnosis with the ECG helps ensure timely and appropriate interventions, potentially improving the patient's outcome. Other options may be relevant in the overall management of a myocardial infarction but do not precede the critical need for immediate ECG assessment. For instance, while administering nitroglycerin can relieve chest pain and improve blood flow, it should follow an ECG to confirm the appropriate clinical context. Similarly, a chest X-ray may assist in evaluating other conditions but is not a priority in the setting of a suspected cardiac event. Starting CPR is reserved for patients who are in cardiac arrest, which is a different clinical scenario than one with a suspected myocardial infarction who is still conscious and responsive.