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ModerateCardiologyST-Elevation Myocardial Infarctionus-abemus-abfmus-abimus-usmle-step-2us-usmle-step-3

A 58-year-old man presents with 1 hour of crushing substernal chest pain radiating to his left arm. ECG shows ST-segment elevation in leads II, III, and aVF. He first arrived to a rural hospital that lacks PCI capability 30 minutes after symptom onset; transfer to a PCI center will take approximately 3 hours. He has no contraindications to fibrinolysis. What is the most appropriate reperfusion strategy?

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