A 60-year-old man presents to a small rural hospital in Queensland with 90 minutes of central chest pain and diaphoresis. ECG shows 3 mm ST elevation ...

Question

A 60-year-old man presents to a small rural hospital in Queensland with 90 minutes of central chest pain and diaphoresis. ECG shows 3 mm ST elevation in leads V2-V5. The nearest PCI-capable centre is 4 hours away by road. What is the most appropriate immediate reperfusion strategy?

Accepted Answer

Administer tenecteplase immediately and arrange urgent transfer to a PCI-capable centre

Answer

Arrange urgent transfer for primary PCI without fibrinolysis

Answer

Give intravenous heparin only and transfer for angiography the following day

Answer

Manage conservatively with oxygen, nitrates and observation

Answer

Give aspirin only and monitor for resolution of pain

au-acem MCQ (SBA): ST-elevation myocardial infarction

A 60-year-old man presents to a small rural hospital in Queensland with 90 minutes of central chest pain and diaphoresis. ECG shows 3 mm ST elevation in leads V2-V5. The nearest PCI-capable centre is 4 hours away by road. What is the most appropriate immediate reperfusion strategy?