skip to main content

ST-elevation myocardial infarction — MCCQE Part 1 MCQ

Instant feedback + full explanation. One question, done properly.

EasyChest PainST-elevation myocardial infarctionMCCQE Part 1

A 58-year-old man with diabetes has 45 minutes of crushing retrosternal pain radiating to the left arm, diaphoresis and 3 mm ST elevation in II, III and aVF. Which of the following is the most appropriate next step?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: A — Activate the STEMI reperfusion pathway with urgent PCI-capable transfer and antiplatelet therapy

Activate the STEMI reperfusion pathway with urgent PCI-capable transfer and antiplatelet therapy is the single best answer because the age, timing, examination findings and investigations in the vignette fit ST-elevation myocardial infarction better than the alternatives. The most tempting distractor is less appropriate because it either treats a neighbouring presentation, delays a time-critical intervention, or ignores a key discriminator in the stem. The remaining options are suboptimal because they would miss the diagnosis, use an investigation or treatment in the wrong sequence, or fail to address safety and follow-up. Canadian practice should be anchored to CCS acute coronary syndrome guidance, with attention to acuity, safety-netting and local provincial pathways.

Reference: CCS acute coronary syndrome guidance