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HardCardiologyST-elevation myocardial infarctionca-mccqe1ca-rcpsc-emca-rcpsc-im

A 68-year-old woman presents to a rural emergency department with 90 minutes of central chest pain and diaphoresis. ECG shows ST elevation in leads II, III and aVF. The nearest percutaneous coronary intervention (PCI) centre is 3 hours away by ground and helicopter transfer is unavailable due to weather. According to Canadian STEMI guidance, what is the BEST reperfusion strategy?

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