In STEMI when PCI is not available, which therapy restores myocardial perfusion?

In STEMI when PCI is not available, which therapy restores myocardial perfusion?

• A. Observation
• B. Beta-blocker therapy
• C. Fibrinolysis
• D. PCI

Answer: (C)

When the goal is to restore perfusion in STEMI and primary PCI isn’t available, the treatment that directly reopens the blocked artery is fibrinolysis. Thrombolytic (fibrinolytic) drugs activate plasmin to break down the fibrin clot that’s occluding the coronary artery, allowing blood flow to be restored to the affected myocardial territory. This is most effective when given as soon as possible after symptom onset, typically within 12 hours, with earlier administration yielding better outcomes. While PCI physically vents the blockage and is preferred when available, fibrinolysis serves as the reperfusion option when PCI cannot be performed promptly. It carries bleeding risks, including intracranial hemorrhage, so contraindications must be considered. Observation would not restore perfusion, and beta-blockers do not reperfuse the blocked artery, leaving fibrinolysis as the correct reperfusion strategy in this scenario.

When the goal is to restore perfusion in STEMI and primary PCI isn’t available, the treatment that directly reopens the blocked artery is fibrinolysis. Thrombolytic (fibrinolytic) drugs activate plasmin to break down the fibrin clot that’s occluding the coronary artery, allowing blood flow to be restored to the affected myocardial territory. This is most effective when given as soon as possible after symptom onset, typically within 12 hours, with earlier administration yielding better outcomes. While PCI physically vents the blockage and is preferred when available, fibrinolysis serves as the reperfusion option when PCI cannot be performed promptly. It carries bleeding risks, including intracranial hemorrhage, so contraindications must be considered. Observation would not restore perfusion, and beta-blockers do not reperfuse the blocked artery, leaving fibrinolysis as the correct reperfusion strategy in this scenario.