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STEMI
Definition
PCI criteria
Management
LT management
Trop + ischaemia changes
- 2+ Limb lead 1mm elevation
- 2+ chest elad 2mm elevation
- LBBB
PCI criteria: 12 hrs from onset of sx and <2hrs from PPCI centres. If >2hrs then consider thrombolysis and transfer.
Mx: DAPT, Lmwh, bisoprolol, analgesia
NSTEMI / UA
Ishaemic changes + trop rise (no trop rise in UA)
nitrates for recurrent chest pain
DAPT + analgesia + nitrates for recurrent chest painUrgent review (<120 after presentation if developing ecg changes /ongoing chest pain/shock or arrhythmia)
Urgent review (<120 after presentation if developing ecg changes /ongoing chest pain/shock or arrhythmia)
Ventricular Arrhythmias
Risk factors
Prognostic features
Usually occurs in first 48 hours after PPCI.
More likely if larger MI and no prior history of coronary disease.
More likely post-procedural if they have any signs of heart failure.
Early PCI, B-blockers help.
No increased 3 year mortality (horizons).
Though higher 30 day and 1 year mortality rates (1/3).
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