Urgent coronary angiography is the next step in the care of our patient. Timely reperfusion can be achieved by several methods. Thrombolytic therapy, is a commonly used method of achieving reperfusion. The goal is to administer it within thirty minutes of presentation to optimize outcome. However, in hospitals with appropriate facilities, timely primary coronary angioplasty is the procedure of choice. The goal is to perform this within ninety minutes of presentation to optimize outcome. As an initial reperfusion strategy, coronary artery bypass graft surgery is rarely indicated.
Urgent coronary angiography will determine the location and severity of the lesions in the coronary arteries and the feasibility of immediate intervention by angioplasty or bypass surgery. Such intervention, particularly with a large infarction, can reduce infarct size, complications and mortality. The earlier the initiation of therapy from the onset of symptoms, the greater the benefit.