Question

A 61-year-old with a 1-hour history of chest pain has STEMI on ECG. He is 2.5 hours from the nearest PCI centre. What is the most appropriate reperfusion strategy now?

Accepted Answer

Immediate fibrinolysis with a fibrin-specific agent and then transfer

Answer

Transfer for primary PCI despite expected 150-minute delay

Answer

Start dual antiplatelets and wait for PCI later today

Answer

Immediate coronary angiography without reperfusion

Answer

No reperfusion if pain improving

Practice question

A 61-year-old with a 1-hour history of chest pain has STEMI on ECG. He is 2.5 hours from the nearest PCI centre. What is the most appropriate reperfusion strategy now?