East Asia Government Practice Test & Exam Prep

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A 58-year-old male presents to the emergency department with severe, crushing substernal chest pain radiating to the left arm and jaw that started 90 minutes ago. ECG reveals 3 mm ST-segment elevation in leads V1 through V4. His blood pressure is 135/85 mmHg and pulse is 88 bpm. What is the immediate, most appropriate reperfusion strategy?

Primary percutaneous coronary intervention (PCI) if achievable within 120 minutes, or immediate fibrinolytic therapy if PCI is unavailable Immediate intravenous unfractionated heparin bolus followed by elective coronary angiography within 72 hours Oral administration of high-dose beta-blockers and nitroglycerin infusion with repeat ECG in 6 hours Transesophageal echocardiography to rule out aortic dissection prior to administering any antiplatelet therapy

Correct Answer:

Primary percutaneous coronary intervention (PCI) if achievable within 120 minutes, or immediate fibrinolytic therapy if PCI is unavailable

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