MRCP2-0903

MRCP2-0903

A 28-year-old man presents to the emergency department with sudden onset of severe left-sided chest pain. His vital signs are as follows: temperature 37.2ºC, blood pressure 165/92 mmHg, pulse 129/min and regular, and respiratory rate 20/min. Upon examination, he appears anxious, diaphoretic, and agitated. His nasal mucosa is atrophic, and both pupils are dilated. Heart sounds are regular without murmurs or rubs, and the lungs are clear. An initial ECG shows ST-segment elevation in leads V4-V6, and a chest x-ray is normal. Laboratory studies reveal elevated troponin T levels.

Which of the following treatment options should be avoided in this patient?