A 28-year-old man presents to the ED with 3 hours of pleuritic chest pain and ST-segment elevations in leads II, III, and aVF. PCI is not immediately ...

Question

A 28-year-old man presents to the ED with 3 hours of pleuritic chest pain and ST-segment elevations in leads II, III, and aVF. PCI is not immediately available; nearest PCI center is 2 hours away. He has no contraindications to fibrinolysis. What is the recommended timing for reperfusion?

Accepted Answer

Give fibrinolysis now and arrange transfer after

Answer

Transfer only; do not give lytics beyond 90 minutes

Answer

Wait for PCI capability to avoid bleeding risk

Answer

Start heparin only and observe

Answer

Administer DAPT and discharge for outpatient PCI

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

A 28-year-old man presents to the ED with 3 hours of pleuritic chest pain and ST-segment elevations in leads II, III, and aVF. PCI is not immediately available; nearest PCI center is 2 hours away. He has no contraindications to fibrinolysis. What is the recommended timing for reperfusion?