Question

A 35-year-old male construction worker in a remote northern community presents to a nursing station with crushing chest pain for 45 minutes. The ECG shows ST elevation in leads V2-V5. The nearest PCI-capable centre is 5 hours away by road; air transport is unavailable due to weather. What is the most appropriate reperfusion strategy?

Accepted Answer

Immediate fibrinolytic therapy with appropriate agent plus transfer when possible

Answer

No reperfusion therapy; manage with oxygen and analgesia only

Answer

Wait for PCI because it is always superior to fibrinolysis

Answer

Administer heparin only and observe

Answer

Delay all treatment until cardiology advice is obtained the next day

Practice question