MI on EKG: The recommended management is immediate PCI with MONA-BASH; do not wait for positive labs. Which option best reflects this approach?

• A. Thrombolytic therapy only
• B. Wait for troponin positivity before treating
• C. Immediate PCI with MONA-BASH; Do not wait for troponin positivity
• D. Medical therapy alone

Answer: (C)

In suspected STEMI, restoring blood flow as quickly as possible is the top priority. Troponin elevation confirms myocardial injury but takes time to become positive, so waiting for those labs would delay reperfusion and worsen outcomes. When PCI can be performed promptly, it provides the most reliable and fastest reperfusion, improving survival compared with thrombolysis. Starting anti-ischemic and antiplatelet therapy (the MONA-BASH approach) while arranging urgent PCI is appropriate, and you should not wait for troponin results before reperfusing. Medical therapy alone without reperfusion misses the critical goal in STEMI.