STEMI Diagnosis and Management

A 62-year-old woman with diabetes and hypertension presents to the emergency department 6 hours after onset of acute anterior chest pain. ECG shows ST elevation in V1–V4 with reciprocal ST depression in II, III, aVF. She has received aspirin 325 mg and clopidogrel 600 mg at a referring centre. Her troponin I is 2.8 ng/mL (normal <0.04). She is haemodynamically stable (BP 128/80, HR 88). The hospital has a functional catheterization laboratory. What is the most appropriate next step?

A 62-year-old man with acute STEMI is being considered for reperfusion therapy. His symptom onset was 3 hours ago. Which single feature best distinguishes a patient suitable for primary percutaneous coronary intervention (PCI) from one who should receive fibrinolytic therapy?

A 52-year-old Indian man with diabetes and hyperlipidemia develops acute chest pain with ST elevation in leads II, III, and aVF. Which is the most common site of coronary artery occlusion in inferior wall STEMI?

A 58-year-old man with diabetes and hypertension presents to the emergency department with acute anterior wall ST-elevation myocardial infarction (STEMI) of 2 hours duration. He is hemodynamically stable with no contraindications to fibrinolysis. The hospital does not have PCI capability and transfer to a PCI-capable centre will take 90 minutes. What is the drug of choice for immediate reperfusion therapy?

A 52-year-old man with acute inferior wall STEMI undergoes successful primary percutaneous coronary intervention (PCI) with stent placement. At the end of the procedure, he is started on dual antiplatelet therapy. Which of the following is the drug of choice for long-term P2Y12 inhibition in this patient?