Question

A 65-year-old man with acute central chest pain started 90 minutes ago. ECG shows ST-elevation in leads II, III, aVF. There is no PCI-capable centre within 2 hours. What is the best immediate reperfusion strategy?

Accepted Answer

Immediate fibrinolysis with tenecteplase

Answer

Primary PCI at nearest PCI centre despite 3-hour transfer delay

Answer

Start dual antiplatelet therapy only and observe

Answer

Thrombolysis deferred pending troponin result

Answer

Urgent stress test

Practice question

A 65-year-old man with acute central chest pain started 90 minutes ago. ECG shows ST-elevation in leads II, III, aVF. There is no PCI-capable centre within 2 hours. What is the best immediate reperfusion strategy?