A 50-year-old woman presented to the AED at 2:00 a.m. with palpitations and chest discomfort. Her BP was 90/50 mmHg and SaO2 99% on room air.
What is the most appropriate management?
Choose the correct answer.
The ECG demonstrates sinus rhythm with frequent PVCs in a bigeminal pattern, which may distract from the primary rhythm.
Notable ST elevation is present in the inferior leads of the conducted QRS complexes, with reciprocal changes in V2-V5, diagnostic of an inferior STEMI.
Given the morphology, the premature complexes are likely of RV outflow tract origin.
Management of an acute STEMI requires emergent reperfusion therapy; primary PCI is the preferred strategy, though fibrinolytic therapy should be administered if PPCI cannot be performed within 120 minutes of medical contact.
