brooklynmed
Forum Newbie
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If pat. comes in w/ typical MI presentation on EKG shows inferior MI ( II, III, AVF) ST elev.....do you first give thrombolytic or immediate PTCA? Is it any different than LAD MI??:
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| Gourdon
Topics: 14
Posts: 87
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I think thrombolytic therapy
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| chemamr
Moderator and PGY2
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why not PTCA?
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| arlete
Intern in 2009!!!!!
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Immediate PTCA if service is available on the premises. If it would take too long to transfer the patient, add the time for transportation + symptoms duration, if the number is too high (2+ hours), thrombolytic is better. There's no difference in treatment for inferior x anterolateral STEMI.
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| Vietnamese
Forum Elite
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Note that inferior MI is subject to get along with Right ventricular MI, then imminent hypotension. Should do some fluid loading before and within thrombolysis/PTCA.
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| arlete
Intern in 2009!!!!!
Topics: 30
Posts: 2,240
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And don't forget to give a glycoprotein IIb/IIIa inhitbitor if the patient is going for PTCA. Fluid loading depending on the clinical presentation. If bradycardia: atropine, sometimes is enough to correct the hypotension.
Aspirin for everybody!
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| me007
Forum Guru
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Thrombolysis is generally preferred to PCI in cases where the time from symptom onset is less than 3 hours and if there would be a delay to PCI, greater than 1-2 additional hours to door-to-balloon time.
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| doyoudig
Forum Guru
Topics: 144
Posts: 613
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if PTCA is availabe such as in tertiary hospitals it is prefferd over thrombolytics bc/ it decr mortality/morbidity and hopsital stay compared to thrombolytics, but if it is not available (do not trnasfer pt to another hopsital for ptca b/c of time factor) better to give thrombolytics if MI onset occured w/in 12 hrs...
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| arlete
Intern in 2009!!!!!
Topics: 30
Posts: 2,240
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This is a nod.
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