Question

A 58-year-old GP working in a small rural town with no onsite CT scanner sees a 62-year-old man with sudden onset of severe central chest pain radiating to the left arm 30 minutes ago. ECG shows 3 mm ST elevation in V2-V5. Retrieval team can arrive in 2 hours, and the nearest PCI centre is 4 hours away. Thrombolytic therapy is available in your practice. What is the most appropriate course of action?

Accepted Answer

Give fibrinolytic therapy now and arrange transfer to PCI centre after

Answer

Wait for retrieval to the PCI centre without giving thrombolysis

Answer

Treat with aspirin only and await retrieval

Answer

Arrange road transfer to PCI centre without reperfusion

Answer

Give morphine only and observe

Practice question