Question

A 64-year-old woman presents with 90 minutes of central chest pain and ST elevation in leads V1–V4. She attends a small district general hospital without primary PCI facilities. The nearest PCI centre is 150 minutes away by blue-light ambulance. What is the most appropriate reperfusion strategy?

Accepted Answer

Offer immediate fibrinolysis in the current hospital and then arrange transfer to a PCI centre

Answer

Arrange immediate transfer for primary PCI despite the delay

Answer

Manage conservatively with dual antiplatelet therapy only

Answer

Delay reperfusion until the troponin result is available

Answer

Give subcutaneous low molecular weight heparin only

Practice question

A 64-year-old woman presents with 90 minutes of central chest pain and ST elevation in leads V1–V4. She attends a small district general hospital without primary PCI facilities. The nearest PCI centre is 150 minutes away by blue-light ambulance. What is the most appropriate reperfusion strategy?