Question

A 64-year-old man presents to an urban emergency department with 90 minutes of central chest pain radiating to his left arm. He is diaphoretic. His ECG shows 2 mm ST-segment elevation in leads V2-V5. The hospital has a 24-hour cardiac catheter laboratory with door-to-balloon times consistently under 90 minutes. What is the most appropriate reperfusion strategy?

Accepted Answer

Primary percutaneous coronary intervention via urgent transfer to the catheter laboratory

Answer

Immediate fibrinolysis with tenecteplase in the emergency department

Answer

Arrange urgent coronary CT angiography before making further decisions

Answer

Conservative medical management with antiplatelets and observation only

Answer

Thrombolysis followed by routine angiography several days later

Practice question