2 Hours Of Crushing in Medicine / Internal Medicine — 45yo Man | Cardiology | SMLE Q#739
SMLE Question #739
Medicine / Internal Medicine
Cardiology
Last updated: February 2026
A 45-year-old man presents to the emergency department with 2 hours of crushing central chest pain radiating to the left arm, with diaphoresis and nausea. He has hypertension and smokes 1 pack/day. ECG shows 2-mm ST-segment elevation in leads II, III, and aVF with reciprocal ST depression in leads I and aVL. The nearest PCI-capable hospital is 3 hours away by ambulance. What is the most appropriate next step in management?
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