Patient with STEMI (-) OMI is now pain free. Is there need for emergent cath lab activation?

I was reading through a stack of ECGs to put in the formal interpretation, and came across this one:This was my interpretation without having any clinical information:" There is suspicion forevolving infarction in inferior, lateral, and posterior walls. " ( " Evolving " means that it has been going on for some time, is not very acute, probably subacute) Then I went into the patient ' s chart:This was a 50-something female who presented from an outside hospital in the very early hours with " NSTEMI. " The patient started having pain the previous evening.  She reported that she was leaving work the previous afternoon when she started having nausea and diaphoresis.  She was able to get home and shortly after returning home started having numbness of her left arm.  2 hours later, she had onset of chest pain.  She went to the ED:This ECG (ECG 1) was recorded at the outside hospital: time zeroThere is minimal STE in inferior leads, with reciprocal ST depression in aVL.  There is a downsloping ST segment in lead V2 and a bit of ST depression in lead V3.  In this clinical situation, this is diagnostic of inferior-posterior OMI. If I saw this, I could activate the cath lab.She was given some nitro and heparin, which resolved her pain.  The pain continued to wax and wane. Troponin I returned at 1.38 ng/mL.  Another ECG (ECG 2) was recorded at 1 hour after arrival:The findings are still present.  The ECG continues to show ische...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs