Atestace Vnitřní lékařství

Practice session

A 58-year-old man presents to a regional Czech community hospital emergency department with 90 minutes of crushing retrosternal chest pain radiating to the left jaw and diaphoresis. His ECG reveals 3 mm ST-segment elevations in leads V1–V4 with reciprocal ST depressions in inferior leads. The local hospital lacks a catheterization laboratory, and the expected transport time to the nearest PCI center in Prague is 45 minutes (estimated door-to-wire time is 75 minutes). According to the European Society of Cardiology (ESC) and Czech Society of Cardiology (ČKS) guidelines for acute STEMI, what is the most appropriate reperfusion strategy?

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