05-26-2009, 01:54 PM
Is angioplasty favored over thrombolysis?
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Cocaine-induced MI - bigdino
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05-26-2009, 01:56 PM
aspirin
diazepam ntg/ccb cardiac cath no role of thromolytic in cocaine mi
05-26-2009, 02:10 PM
yes and no role of b blocker either
benzodiazepam is the doc with supportive treatment
05-26-2009, 02:25 PM
no BB only if its vasospasm and chest pain, once MI is developed then definitely BB.
Benzo only when pt presents with chest pain due to cocaine, but in the setting of MI the management is the same for all MI's regardless of etiology. cardiac cath, no role of thrombolysis
05-26-2009, 04:05 PM
When do you order cardiac Cath ? While the patien is in ER or when the patien is in ward. ?
05-26-2009, 04:57 PM
if the pt has MI in the ER, if unstable angina or NSTEMI can send pt to CCU and then it depends. For pts with Unstable angina and NSTEMI going to cath is determined based on TEMI risk score , which is not at the level of this exam.
05-26-2009, 05:01 PM
Yes , but the case in CCS does not close if you order Card cath at the begining. If is like that when shold we order it?
05-26-2009, 05:09 PM
As soon as possible, especially if its STEMI, there are several studies that showed the earlier door to balloon time has good prognosis post MI. but make sure to give the routine meds first.
As far CCS, i think they want us to order cardiology consult, because remember as an ER Doctor, that is what you do, and going to cath is determined by the cardiologyst. So they want us to tx the pt as if we are the ER doc or internist, so you do everything until cardiologyst sees the pt, thats why you order cath at the end. But, in real life as soon as the pt comes to the ER the Cath lab is activated and pt is taken there as soon as possible. |
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