<prompt> A 65 year old elderly male has history of sweating and chest pain for last 24 hrs with the following ECG. Which of the following is not given in managing the patient?AspirinStatinThrombolytic therapyMorphine  <response>: Ans. C. Thrombolytic therapyFirst let us diagnose the ECG; we need to know the following points:E.C.G changes in acute infarctionEarly acute phase with - in hoursFully evolved phaseOld infarction resolution phaseElevation of ST segmentPathological Q warePathogical Q waveTall wide peaked T waveElevated ST segment being to resolveT wave inverts.ST segment and T wave may be normalST segment elevation, unlike depression, will localize to the ECG lead of the affected myocardium. Note that 1mm of ST elevation in 2 contiguous leads is required to diagnose STEMI, however there are two major exceptions.a. Anterior STEMI requires 2mm of ST elevation in V2 and V3 in men 40 years old or 1.5mm in women according to the ACCAHA definition.b. Posterior STEMI frequently has ST depression in V1-V3 instead of elevation since the vectors are completely reversed. Hence, this is an ECG of anterior STEMI.In STEMI, thrombolysis or PCI primary PCI are effective methods to restore coronary blood flow and salvage myocardium within the first 12 h after onset of chest pain.ST elevation MI STEMI Immediate management:a. Nitratesb. Morphinec. Oxygend. AspirinStart adjunctive treatmenta. Beta blockers IVb. Nitroglycerine IVc. Heparin IVReperfusion therapy is the definitive treatment of choice if patient present 12 hours.a. Thrombolysis Streptokinaseb. Early primary PCI 