Question

A 68-year-old presents 60 minutes after onset of chest pain. ECG shows ST elevation in V2-V5. Primary PCI is 70 minutes away by direct transfer. Best immediate strategy?

Accepted Answer

Primary PCI pathway with transfer to cath lab

Answer

Immediate fibrinolysis with tenecteplase

Answer

Give clopidogrel and arrange urgent CT aorta

Answer

Start IV nitrates and observe for 6 hours

Answer

Thrombolysis after repeat ECG at 2 hours

Practice question

A 68-year-old presents 60 minutes after onset of chest pain. ECG shows ST elevation in V2-V5. Primary PCI is 70 minutes away by direct transfer. Best immediate strategy?