Question

A 62-year-old man presents with central crushing chest pain for 90 minutes, sweating and nausea. ECG shows ST elevation in leads II, III and aVF. He has no contraindications to reperfusion and is 20 minutes from a hospital with 24-7 percutaneous coronary intervention (PCI). What is the most appropriate next step?

Accepted Answer

Give oral aspirin and arrange urgent primary PCI

Answer

Start a heparin infusion and observe for evolution of ECG changes

Answer

Give aspirin and clopidogrel and plan elective PCI the next day

Answer

Administer thrombolysis in the emergency department and discharge if pain settles

Answer

Arrange outpatient cardiology review with a treadmill test

Practice question