In suspected acute coronary syndrome, what is the initial antiplatelet therapy you should administer?

• A. Chewed aspirin 81 mg
• B. Chewed aspirin 162-325 mg
• C. Intravenous heparin
• D. Clopidogrel 300 mg loading

Answer: (C)

Rapid platelet inhibition is the goal in suspected ACS. Chewing aspirin provides fast absorption and a quick antiplatelet effect, which helps blunt ongoing thrombosis at the culprit lesion. The recommended loading dose is 162–325 mg, and chewing it accelerates onset compared with swallowing. Intravenous heparin is an anticoagulant, not an antiplatelet therapy, so it does not fulfill the need for immediate platelet inhibition. Clopidogrel can be added as part of dual antiplatelet therapy, but the initial step is a chewable aspirin loading dose to achieve rapid platelet suppression.