If PCI cannot be performed within 120 minutes of arrival for STE-ACS, what treatment should be considered?

In the context of ST-Elevation Myocardial Infarction (STE-ACS), timely intervention is critical for improving outcomes. When Percutaneous Coronary Intervention (PCI) cannot be performed within 120 minutes of a patient's arrival at the hospital, fibrinolytic therapy becomes a viable and recommended treatment option. Fibrinolytics work by dissolving the thrombus blocking the coronary artery, thereby restoring blood flow to the heart muscle. Administering this therapy as soon as possible can significantly reduce myocardial damage and improve chances of survival.

Alternative treatments, such as coronary artery bypass grafting, are typically not the first line of intervention in the acute setting where rapid reperfusion is needed. Angioplasty is essentially part of PCI and cannot be performed if PCI itself is not an option. Balloon pump insertion is generally used for hemodynamic support but does not address the underlying thrombus causing the obstruction in the coronary artery. Thus, when rapid restoration of coronary flow is crucial, fibrinolytic therapy is the most appropriate and effective treatment if PCI is not feasible within the specified time frame.