What additional diagnostic test is indicated for a patient with ST segment elevation before administering nitroglycerin?

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In the presence of ST segment elevation, particularly when it may suggest an inferior ST elevation myocardial infarction (MI), using right-sided leads for an electrocardiogram (EKG) helps in diagnosing the possibility of right ventricular MI. This condition can occur when there is occlusion of the right coronary artery, often in conjunction with inferior MIs.

Administering nitroglycerin in cases of right ventricular MI without prior evaluation can lead to complications, as nitroglycerin can decrease preload and potentially worsen hypotension in these patients. Therefore, confirming the involvement of the right side of the heart through EKG with right-sided leads is crucial before providing treatment.

While chest X-ray (CXR) can be useful in assessing other potential causes of chest pain (like aortic dissection or pneumothorax), it does not provide definitive information regarding ST segment elevation. A D-dimer test is primarily used to evaluate for thrombosis and is not pertinent in this scenario where ST elevation suggests an acute coronary syndrome. Echocardiograms are valuable for assessing cardiac function and wall motion abnormalities but are not the immediate next step in evaluating ST segment elevations compared to assessing specific myocardial involvement with EKG leads. Thus, obtaining a right-sided EKG is

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