A 60-year-old with 90 minutes of crushing chest pain presents to a rural ED without PCI capability. First medical contact-to-device time to the neares...

Question

A 60-year-old with 90 minutes of crushing chest pain presents to a rural ED without PCI capability. First medical contact-to-device time to the nearest PCI center is estimated at 140 minutes. ECG shows anterior STEMI. What is the best next step?

Accepted Answer

Administer fibrinolysis now and arrange transfer after lysis

Answer

Immediate transfer for primary PCI despite delay

Answer

Give clopidogrel only and observe

Answer

Start heparin only and wait for PCI availability

Answer

Schedule PCI for tomorrow morning

us-usmle-step-2 MCQ (SBA): STEMI

A 60-year-old with 90 minutes of crushing chest pain presents to a rural ED without PCI capability. First medical contact-to-device time to the nearest PCI center is estimated at 140 minutes. ECG shows anterior STEMI. What is the best next step?