Question

A 58-year-old man presents to a small rural hospital with 2 hours of central chest pain radiating to the left arm. ECG shows ST depression and T-wave inversion in lateral leads. Troponin is pending. The nearest PCI-capable centre is 3 hours away by road and retrieval is available. He is haemodynamically stable but ongoing pain persists despite initial nitrates. What is the most appropriate next step?

Accepted Answer

Contact the retrieval service and arrange transfer to a higher-level centre for possible invasive management while commencing guideline-directed medical therapy

Answer

Discharge home and arrange outpatient stress test

Answer

Admit locally without contacting retrieval and wait for troponin result

Answer

Give thrombolysis immediately for presumed STEMI

Answer

Start only paracetamol and observe

Practice question