Question

A 58-year-old man presents with 90 minutes of central chest pain radiating to his left arm, associated with sweating and nausea. ECG shows 3 mm ST elevation in leads V2–V4. The nearest primary PCI centre is 30 minutes away. What is the most appropriate management strategy?

Accepted Answer

Arrange urgent transfer for primary PCI

Answer

Give thrombolysis immediately in the emergency department

Answer

Start aspirin alone and arrange outpatient cardiology review

Answer

Start a beta-blocker and observe with serial ECGs

Answer

Give sublingual Glyceryl trinitrate and discharge if pain settles

Practice question

A 58-year-old man presents with 90 minutes of central chest pain radiating to his left arm, associated with sweating and nausea. ECG shows 3 mm ST elevation in leads V2–V4. The nearest primary PCI centre is 30 minutes away. What is the most appropriate management strategy?