http://www.fpnotebook.com/
High Risk Acute Coronary Syndrome ManagementAka: ST Elevation MI, Q-Wave MI, Myocardial Infarction Protocol
- See Also
- MI Adjunctive Therapy
- Criteria: Myocardial Infarction
- ST Elevation 1 mm or more in 2 or more contiguous leads
- New Left Bundle Branch Block obscuring ST segments
- Presumed new Left Bundle Branch Block
- Management: Protocol
- Time from Chest Pain onset <12 hours
- Start MI Adjunctive Therapy, do not delay reperfusion
- Immediate Reperfusion Strategy
- Angioplasty with cardiothoracic back-up (preferred)
- Goal within 90 minutes of ED arrival
- Thrombolytic therapy (if Angioplasty not available)
- Goal within 30 minutes of ED arrival
- Efficacy: Comparing Angioplasty with Thrombolytic
- Similar outcomes and complication rates
- Mehta (2002) J Am Coll Cardiol 40:1034
- Angioplasty preferred if transport delay <1 hour
- Andersen (2003) N Engl J Med 349:733
- Time from Chest Pain onset >12 hours
- Manage as Myocardial Ischemia Protocol
- References
- (2000) Circulation 102(suppl I):I
Navigation Tree
