skip to main content

ST-elevation myocardial infarction — RCPSC IM MCQ

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

EasyCardiologyST-elevation myocardial infarctionRCPSC IM

A 58-year-old man in a rural emergency department has 45 minutes of crushing chest pain. ECG shows 3 mm ST elevation in II, III and aVF. The nearest PCI-capable centre cannot accept transfer for 130 minutes. He has no contraindication to thrombolysis and blood pressure is stable. 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 — Administer fibrinolysis and arrange rescue or routine early PCI transfer

When timely primary PCI is not feasible for STEMI, fibrinolysis should be given if no contraindication exists, with transfer for rescue PCI if reperfusion fails or routine early angiography after lysis.

Reference: Canadian Cardiovascular Society acute coronary syndrome guidance