A Text Message in the Middle of the night. Do you give thrombolytics?
I awoke in the morning and discovered a text with this ECG that was sent 6 hours prior by a former resident: “60 year old with classic…
Incredible case of evolution of terminal QRS distortion, then resolution after thrombolytics
For more on Terminal QRS distortion, see these posts: Best Explanation of Terminal QRS Distortion in Diagnosis of Electrocardiographically…
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…
Intravenous Nitroglycerine in STEMI, with data: Avoid its use if giving tPA
If you are giving tPA to patients with STEMI, it is wise to avoid IV nitroglycerine. I am revisiting this topic because of a recent case…
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…