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ST-elevation myocardial infarction — RACGP Fellowship MCQ

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

ModerateEmergency presentations in general practiceST-elevation myocardial infarctionRACGP Fellowship

A 56‑year‑old man presents to your general practice clinic with crushing central chest pain radiating to the left arm for 40 minutes. He is pale and sweaty. Blood pressure is 96/60 mmHg, heart rate 104/min. ECG shows ST‑segment elevation in leads II, III and aVF. What is the most appropriate management?

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

Reveal the answer and explanation

Correct answer: B — Call an ambulance immediately and give aspirin 300 mg if not contraindicated

Explanation lettering: C = shown as A · D = shown as B · E = shown as C · B = shown as D · A = shown as E

This patient has an acute inferior STEMI within the 12‑hour reperfusion window, with signs of haemodynamic compromise. Australian guidelines mandate immediate emergency reperfusion. The correct response is to call an ambulance to activate pre‑hospital ECG, notification and pathway activation for primary PCI or fibrinolysis, and give aspirin 300 mg promptly if not contraindicated. Options A, B and C dangerously delay treatment; option E bypasses trained pre‑hospital care and optimal systems‑based reperfusion pathways.

Reference: Diagnosis and management of acute coronary syndromes — Australian Prescriber (Therapeutic Guidelines), 2021; NHFA‑CSANZ ACS Guideline, April 2025