Question

A 66-year-old man is brought to the emergency department with crushing chest pain for 45 minutes. ECG shows ST elevation in leads II, III, and aVF. He is in a rural hospital where the nearest PCI centre is 4.5 hours away by ground and air transport is delayed by weather. According to CCS STEMI guidelines, what is the most appropriate reperfusion strategy?

Accepted Answer

Immediate fibrinolysis with timely transfer to a PCI-capable centre for possible rescue PCI

Answer

Withhold reperfusion therapy because of distance to PCI

Answer

Wait for transfer and primary PCI even if door-to-balloon time exceeds 3 hours

Answer

Administer dual antiplatelet therapy only

Answer

Use heparin alone without reperfusion

Practice question