Question

A 58-year-old man presents to a small rural hospital 200 km from the nearest tertiary centre with 2 hours of central chest pain suggestive of ACS. ECG shows 3 mm ST elevation in V2-V5. There is no PCI capability on site, and the estimated transfer time to the PCI centre is 3 hours. What is the most appropriate reperfusion strategy?

Accepted Answer

Administer fibrinolysis now and arrange transfer after lysis

Answer

Arrange transfer for primary PCI only; do not give thrombolysis

Answer

Give aspirin only and observe locally

Answer

Arrange air transfer but delay any reperfusion until arrival at PCI centre

Answer

Give clopidogrel only and monitor

Practice question