Question

A 65-year-old woman presents with severe crushing chest pain radiating to her jaw. The ED team performs an ECG showing ST-elevation in V2-V5. There is no PCI facility on site; the nearest PCI centre is 4 hours away. Symptom onset was 45 minutes ago. What is the most appropriate reperfusion strategy?

Accepted Answer

Administer fibrinolytic therapy as soon as possible and then transfer to PCI centre

Answer

Immediate transfer for primary PCI, no thrombolysis

Answer

No reperfusion because onset was <1 hour

Answer

Transfer to PCI centre after 12 hours for elective angiography

Answer

Give heparin only and observe

Practice question