Question

A 58-year-old man presents to the emergency department with 90 minutes of central crushing chest pain radiating to the left arm. He is pale and clammy. ECG shows 3 mm ST elevation in leads V2–V5. The hospital has 24-hour primary PCI. What is the most appropriate immediate reperfusion strategy?

Accepted Answer

Immediate transfer for primary percutaneous coronary intervention

Answer

Immediate intravenous thrombolysis with alteplase

Answer

Start intravenous unfractionated heparin and arrange coronary angiography within 72 hours

Answer

High-dose Atorvastatin and arrange outpatient CT coronary angiography

Answer

Admit for monitoring and repeat troponin at 12 hours

Practice question

A 58-year-old man presents to the emergency department with 90 minutes of central crushing chest pain radiating to the left arm. He is pale and clammy. ECG shows 3 mm ST elevation in leads V2–V5. The hospital has 24-hour primary PCI. What is the most appropriate immediate reperfusion strategy?