In management of STEMI diagnosed on ECG, what is the recommended approach regarding lab confirmation?

• A. Do not wait for labs before PCI
• B. Wait for troponin positivity before PCI
• C. Use antibiotics first
• D. Schedule outpatient follow-up

Answer: (A)

When STEMI is diagnosed by ECG, the priority is immediate reperfusion rather than waiting for lab confirmation. Troponin and other markers take time to rise and confirm infarction, but delaying treatment to obtain those results worsens outcomes by delaying restoration of blood flow. Activate the cath lab and proceed with PCI as soon as possible (aim for within about 90 minutes if PCI is available; if not, consider timely fibrinolysis). Labs should be drawn, yet they should not block urgent reperfusion.

The other approaches don’t fit because waiting for troponin positivity would cause harmful delays, antibiotics are not indicated for STEMI, and outpatient follow-up is inappropriate in the acute setting.