skip to main content

ST-elevation myocardial infarction — SCE Acute Medicine MCQ

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

EasyCardiovascular medicineST-elevation myocardial infarctionSCE Acute Medicine

A 72-year-old man with hypertension develops crushing central chest pain 70 minutes before arrival. ECG shows 2 mm ST elevation in II, III and aVF with reciprocal depression in I and aVL. He has taken no antiplatelet therapy and has no allergy history. The nearest primary PCI centre can accept him immediately. What is the most appropriate next step in management?

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

Reveal the answer and explanation

Correct answer: C — Give aspirin 300 mg and transfer for primary PCI

This is an inferior STEMI within the reperfusion window and primary PCI is preferred when it can be delivered promptly. NICE recommends aspirin 300 mg as soon as possible unless contraindicated. Fibrinolysis is reserved for circumstances where timely PCI is not feasible, and waiting for troponin is inappropriate when diagnostic ST elevation is present.

Reference: NICE NG185