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ST-elevation myocardial infarction — DIPIMC MCQ

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EasyMedical EmergenciesST-elevation myocardial infarctionDIPIMCDipIMC

A 62-year-old has 40 minutes of crushing central chest pain radiating to the left arm. He is sweaty and nauseated. A 12-lead ECG shows ST-segment elevation in leads V1 to V4. He has already taken aspirin. You are 35 minutes from a primary PCI centre. What is the most appropriate management?

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Correct answer: E — Pre-alert the PCI centre and transfer for primary PCI

An acute ST-elevation myocardial infarction is best treated by timely reperfusion, and where primary percutaneous coronary intervention is accessible within recommended times it is preferred, with a pre-alert so the catheter laboratory is ready. Thrombolysis is reserved for when timely intervention cannot be achieved. Antiplatelet therapy should not wait for troponin, and outpatient referral is unsafe. Pearl: the interval from first medical contact to reperfusion drives outcome, so an early pre-alert matters.

Reference: JRCALC Clinical Guidelines