If cardiac arrest is due to coronary thrombosis, what definitive therapy should be pursued?

If cardiac arrest is due to coronary thrombosis, what definitive therapy should be pursued?

• A. Initiate cooling therapy before reperfusion
• B. Emergent coronary angiography with PCI as indicated
• C. Observation and medical therapy
• D. Defibrillation only

Answer: (B)

When cardiac arrest is caused by a coronary thrombosis, the immediate goal is to restore blood flow through the blocked artery. Emergent coronary angiography with PCI to open the culprit vessel provides definitive therapy by re-establishing perfusion to the heart muscle, which lowers mortality and limits myocardial damage. Delaying reperfusion to start cooling therapy before PCI can worsen outcomes, since time is critical to reopen the artery. Therapeutic hypothermia after ROSC can be considered in comatose patients, but it should not precede reperfusion. Observation or purely medical therapy does not address the underlying occlusion, and defibrillation alone manages the rhythm but not the cause.

When cardiac arrest is caused by a coronary thrombosis, the immediate goal is to restore blood flow through the blocked artery. Emergent coronary angiography with PCI to open the culprit vessel provides definitive therapy by re-establishing perfusion to the heart muscle, which lowers mortality and limits myocardial damage.

Delaying reperfusion to start cooling therapy before PCI can worsen outcomes, since time is critical to reopen the artery. Therapeutic hypothermia after ROSC can be considered in comatose patients, but it should not precede reperfusion. Observation or purely medical therapy does not address the underlying occlusion, and defibrillation alone manages the rhythm but not the cause.