Question

A 58-year-old man presents to a remote nursing station in northern Canada with 45 minutes of crushing chest pain and diaphoresis. ECG shows clear ST elevation in leads V2-V4. There is no on-site catheterisation laboratory; nearest PCI centre is several hours away by air. What is the most appropriate immediate management strategy?

Accepted Answer

Administer aspirin, clopidogrel, appropriate anticoagulation and arrange urgent thrombolysis if there are no contraindications, while organising transfer.

Answer

Wait for air transfer to the PCI centre without further treatment.

Answer

Do nothing until cardiac enzymes return.

Answer

Discharge home because PCI is not available locally.

Answer

Offer only oxygen and nitrates without reperfusion therapy.

Practice question