Question

A 45-year-old man presents with chest pain and ST-segment elevation in leads II, III and aVF on ECG. Onset of pain was 2 hours ago. He is in a rural hospital without PCI facilities; the nearest PCI-capable centre is 3 hours away by road. What is the most appropriate reperfusion strategy?

Accepted Answer

Administer intravenous thrombolysis immediately and arrange transfer after

Answer

Arrange transfer to PCI centre without thrombolysis

Answer

Give aspirin only and monitor

Answer

Start a glycoprotein IIb/IIIa inhibitor and transfer

Answer

No reperfusion because it is too late

Practice question

A 45-year-old man presents with chest pain and ST-segment elevation in leads II, III and aVF on ECG. Onset of pain was 2 hours ago. He is in a rural hospital without PCI facilities; the nearest PCI-capable centre is 3 hours away by road. What is the most appropriate reperfusion strategy?