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MediumCardiologyST-elevation myocardial infarctionca-mccqe1ca-rcpsc-em

A 62-year-old man presents to the emergency department 60 minutes after onset of severe central chest pain radiating to his left arm. ECG shows ST elevation in leads II, III and aVF. He lives in a rural community where the nearest percutaneous coronary intervention (PCI) centre is 250 km away with an estimated transfer time of 3 hours. What is the best reperfusion strategy?

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