Question

A 58-year-old man presents with central crushing chest pain for 90 minutes. ECG shows ST elevation in leads II, III and aVF. PCI-capable centre is 3 hours away by road and helicopter transfer is not immediately available. What is the MOST appropriate immediate reperfusion strategy?

Accepted Answer

Administer thrombolytic therapy immediately, then arrange transfer for possible rescue PCI

Answer

Give aspirin only and await transfer for PCI

Answer

Arrange urgent CT coronary angiography before any reperfusion

Answer

Start heparin infusion without reperfusion therapy

Answer

Provide morphine and oxygen only while awaiting cardiology review

Practice question

A 58-year-old man presents with central crushing chest pain for 90 minutes. ECG shows ST elevation in leads II, III and aVF. PCI-capable centre is 3 hours away by road and helicopter transfer is not immediately available. What is the MOST appropriate immediate reperfusion strategy?