Should this patient get thrombolytics? When should PCI be performed after thrombolytics?
This was sent by an old friend, who was working with a physician assistant student, Lily McLean. She had just that minute downloaded the Queen…
A man in his 30s with greater than 12 hours of chest pain
Written by Bobby Nicholson MD, with edits by Meyers A man in his early 30s presented at 7:35am to the ED with chest pain (7/10)…
A man in his 30s with 12 hours of chest pain; is the ECG consistent with 12 hours of occlusion?
Written by Pendell Meyers, submitted by Siva Vittozzi-Wong A man in his 30s with history of hypertension, hyperlipidemia, and diabetes…
Do you want to be interrupted to view what the computer calls normal or nonspecific ECGs? 2 cases at once!
Two Cases Male Patient I was handed this ECG of a 40-something male patient. It was recorded at triage. The chief complaint was…
15 hours of chest pain. Too late for thrombolytics, right? Unstable Angina still exists.
The time window for therapy with thrombolytics is up to 12 hours after the onset of chest pain, based on many studies done in the thrombolytic…
Is this acute STEMI? LV Aneurysm? Would you give Thrombolytics?
Recently I posted a case describing “Acuteness” on the ECG and how to assess whether it is too late for reperfusion, especially…
9 Hours of Chest Pain and Deep Q-waves: Is it too late for Thrombolytics? (Time Window for Reperfusion; Acuteness on the ECG)
A 50 year old hypertensive presented with 9 hours of central crushing chest pain. BP was 250/120, and after placement on an IV nitroglycerine…
5 hours of chest pain. How acute is the STEMI?
A male is his 30’s with h/o HTN presented after 6 hours of chest pain. The pain was crushing and substernal, associated with…
Four anterior STEMIs: acute and reperfused vs. won’t reperfuse, subacute and reperfused vs. not reperfused
These 4 recent cases illustrate acute and subacute MI with reperfusion and absence of reperfusion (or failed reperfusion). QS-waves and…