Question

A 62-year-old man presents to a small rural hospital with 90 minutes of central crushing chest pain radiating to his left arm, associated with diaphoresis and nausea. ECG shows ST elevation in leads II, III and aVF. The nearest PCI-capable centre is 4 hours away by road and retrieval service is delayed by weather. According to Australian ACS and ANZCOR guidelines, what is the most appropriate reperfusion strategy?

Accepted Answer

Administer thrombolytic therapy as soon as possible, then arrange transfer

Answer

Arrange immediate transfer without reperfusion and give only analgesia and oxygen

Answer

Give aspirin and commence heparin but no reperfusion therapy

Answer

Wait until PCI is available within 12 hours before considering any reperfusion

Answer

Offer no reperfusion because presentation is within 2 hours

Practice question