Question

A 59-year-old man presents to the ED with sudden onset chest pain radiating to the left arm for 90 minutes. ECG shows 2-mm ST-segment elevations in leads II, III, and aVF. He has no contraindications to fibrinolysis, but the nearest PCI-capable center is 4 hours away by ground transport. What is the best reperfusion strategy?

Accepted Answer

Administer fibrinolytic therapy now in this hospital

Answer

Arrange immediate transfer for primary PCI despite the 4-hour delay

Answer

Treat with dual antiplatelet therapy only and monitor

Answer

Start IV heparin only without reperfusion

Answer

Schedule elective angiography within 24 hours

Practice question