24th April 2024

A 45-year-old male obese smoker with a past medical history of hypertension and hypercholesterolaemia presents to the emergency department with central crushing chest pain, which started approximately five hours ago while he was watching TV.

A 45-year-old male obese smoker with a past medical history of hypertension and hypercholesterolaemia presents to the emergency department with central crushing chest pain, which started approximately five hours ago while he was watching TV. He is brought in by ambulance with suspected ACS and has received 300mg aspirin, IV morphine and cyclizine. His ECG shows > 2 mm ST segment elevation in leads V4-6. His capillary blood glucose is 9.5mmol/litre. The nearest PCI centre is 90 minutes away by ambulance. What is your initial management plan? 

Select the SINGLE most appropriate option from the list below. Select ONE option only.