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In this interactive program, Dr James Hoekstra discusses the case of a 76-year-old woman who presents to the emergency department (ED) with fatigue, weakness, and shortness of breath. Dr Hoekstra addresses atypical presentation of, and risk stratification for, acute coronary syndromes in the elderly patient. He also addresses appropriate pharmacologic therapy, minimizing door-to-treatment time, and the choice of fibrinolytic therapy or percutaneous coronary intervention for the patient with ST-elevation myocardial infarction (STEMI). This case will examine the guidelines-based course of therapy that was implemented for this patient and will discuss the evidence base that supports this treatment approach for the elderly patient presenting to the ED with STEMI. |