27th February 2024

A 65 year old man is brought to a tertiary hospital with a history of sudden-onset chest pain and tightness.

A 65 year old man is brought to a tertiary hospital with a history of sudden-onset chest pain and tightness. He is in excruciating pain and unable to provide a cohesive history however according to the paramedics, his symptoms started 6 hours ago. On examination, he is clammy with vitals of BP 100/80, HR 123, Temp 36.8, O2 sats 96% on RA and RR 24.
An urgent ECG is obtained which shows:

Select the single, most appropriate immediate management option.