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MediumCardiologyST-elevation myocardial infarctionau-amcau-racp

A 62-year-old man presents to the emergency department with central chest pain for 90 minutes, associated with diaphoresis and nausea. His ECG shows 2 mm ST elevation in leads II, III and aVF with reciprocal ST depression in V2-V3. There is no access to percutaneous coronary intervention within 120 minutes. What is the most appropriate immediate reperfusion strategy?

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