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HardCardiologyST-elevation myocardial infarctionau-amcau-acemau-racp

A 62-year-old man presents to a small rural hospital 2 hours after the sudden onset of severe central chest pain. ECG shows ST elevation in leads V2-V5. The nearest PCI-capable centre is 4 hours away by road and helicopter retrieval will take at least 3 hours. He has no contraindications to fibrinolysis. What is the most appropriate reperfusion strategy?

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