Best treatment option? ECG Quiz
Best treatment option? ECG Quiz
What would be the best treatment option for the person with this ECG?
ECG shows upsloping ST segment elevation in inferior leads II, III and aVF and ST depression in I and aVL. A premature beat possibly of ventricular origin, is seen leads V1-V3. PR interval is slightly prolonged. Last part of the ECG shows an irregular rhythm which could be onset of transient atrial fibrillation. Overall it fits in with acute STEMI of inferior wall and the best option is primary angioplasty. Target door to balloon time is less than one and a half hours for primary percutaneous intervention.
If the person presents to a non-PCI capable center, transfer to PCI capable centre if final opening up of the vessel can be attained in about 2 hours. Target Door-in Door-out time for transfer is less than 30 minutes. In case there is no option for PCI, thrombolysis is done if there are no contraindications. Elective transfer to PCI capable centre can be done in 3-24 hours. Failed thrombolysis is another indication for transfer to PCI capable centre.
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About The Author
Johnson Francis
Former Professor of Cardiology, Calicut Govt. Medical Kozhikode, Kerala, India. Editor-in-Chief, BMH Medical Journal
Primary angioplasty
Primary angioplasty – as it is a inferoposterior MI
Correct answer
Correct answer
Inferior wall MI with posterior extension…
Ideally angioplasty should be done
If a patient present to a PCI capable hospital..
If patient presents to a non PCI capable hospital and he can be transferred to a PCI capable one within 90 minutes., again angioplasty is preferred..
Else thrombolysis with TNK if there is no absolute contraindication to thrombolysis….
IV MAGNESIUM HAS ROLE IN POLYMORPHIC VT..
IV LIGNOCAINE IN REFRACTORY VT..
CABG IN TVD/ANATOMICALLY UNSUITABLE LESIONS…
Excellent!