A 45-year-old man arrives at a rural emergency department complaining of severe chest pain, sweating, and nausea. The symptoms started abruptly an hour ago. He has no notable medical history. His father died at the age of 50 from sudden onset chest pain. Every day, the patient smokes a pack of cigarettes. He does not take any medications and is not allergic to any drugs. The examination reveals normal heart and breathing sounds. Leads II, III, and aVF show sinus tachycardia with ST segment elevation. The patient's acute condition is being managed medically. Following initial treatment, the chest pain subsides and a reperfusion complex ventricular arrhythmia develops. The arrhythmia is asymptomatic and goes away on its own. Which of the following drugs is most likely responsible for rapid reperfusion in this patient?

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Quizplus · Accepted Answer

Eductional Objective: Tissue plasminogen activator (tPA) converts plasminogen to plasmin, which then breaks down the fibrin clot in the fibrinolytic pathway. In patients with ST-elevation myocardial infarction who are unable to undergo timely percutaneous coronary intervention, administration of a tPA analogue (e.g., alteplase, tenecteplase, streptokinase) causes fibrinolysis and can restore myocardial perfusion.

A 45-Year-Old Man Arrives at a Rural Emergency Department Complaining