Examen Único De Residencias Córdoba (Medicina) Practice Questions - Córdoba Health Residencies Single Examination (Examen Único De Residencias En Salud - Córdoba Medicina) Exam

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A 58-year-old man presents to the emergency department with 90 minutes of crushing substernal chest pain radiating to the left arm and diaphoresis. An ECG shows 3 mm ST-segment elevation in leads II, III, and aVF with reciprocal ST depression in leads I and aVL. The nearest primary percutaneous coronary intervention (PCI) facility is located 3 hours away. According to Argentine and international cardiology guidelines, what is the most appropriate immediate reperfusion strategy?

Immediate intravenous fibrinolytic therapy (e.g., tenecteplase or alteplase) within 10 minutes of diagnosis, followed by transfer to a PCI-capable center Emergency interfacility transfer for primary percutaneous coronary intervention without administering fibrinolysis Administration of high-dose intravenous unfractionated heparin and observation in the coronary care unit Urgent coronary artery bypass graft (CABG) surgery consultation without medical reperfusion

Correct Answer:

Immediate intravenous fibrinolytic therapy (e.g., tenecteplase or alteplase) within 10 minutes of diagnosis, followed by transfer to a PCI-capable center

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