Any time after symptom onset + ongoing ischemia or instability… — MedQube — TG.ME

Any time after symptom onset + ongoing ischemia or instability (persistent chest pain, cardiogenic shock, acute HF, life-threatening VT/VF, or mechanical complications) → Immediate coronary angiography and primary PCI (Class I). 12–48 hours + hemodynamically stable, no ongoing ischemia → Routine primary PCI should be considered (Class IIa, Level B). >48 hours + stable, asymptomatic, occluded infarct-related artery → Routine PCI is NOT recommended (Class III: No Benefit). >48 hours + recurrent ischemia, persistent chest pain, HF, shock, malignant arrhythmias, or mechanical complications → Urgent angiography ± PCI is indicated despite late presentation.

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