A patient with anterior STEMI has successful primary PCI to an occluded proximal LAD. He remains in cardiogenic shock and angiography shows severe

Question

A patient with anterior STEMI has successful primary PCI to an occluded proximal LAD. He remains in cardiogenic shock and angiography shows severe but stable lesions in the circumflex and right coronary arteries. What is the preferred revascularisation strategy at the index procedure?

Accepted Answer

Treat the infarct-related artery only initially and plan staged assessment of non-culprit lesions

Answer

Insert an intra-aortic balloon pump routinely, then perform complete multivessel PCI

Answer

Perform immediate PCI to every angiographic stenosis before leaving the laboratory

Answer

Use fractional-flow reserve during shock to select all non-culprit lesions for immediate PCI

Answer

Abandon PCI and proceed directly to emergency multivessel CABG despite successful LAD reperfusion

Severe AR Surgical Indication — RACP Adult Medicine MCQ

A patient with anterior STEMI has successful primary PCI to an occluded proximal LAD. He remains in cardiogenic shock and angiography shows severe but stable lesions in the circumflex and right coronary arteries. What is the preferred revascularisation strategy at the index procedure?