On arrival in the ED the patient with suspected acute MI should immediately receive (1) oxygen by nasal prongs; (2) sublingual nitroglycerin (unless systolic arterial pressure is less than 90 mm Hg or heart rate is less than 50 or greater than 100 beats per minute [bpm]); (3) adequate analgesia (with morphine sulfate or meperidine); and (4) aspirin, 160 to 325 mg orally.