Early invasive if
Grace
> 140
Immediate for NSTEMI if:
Refractory angina
HD or electrical instability
Very high risk score
Need to know coronary anatomy before giving…
Prasugrel
Fondaparinux can be given if…
Ischemia guided strategy, no planned PCI
VSD vs Pap mm rupture vs RV infarct presentation
VSD - harsh murmur, 50% anterior MI, patient lies supine, without pulmonary congestion
Pap - flash pulm edema, can have soft murmur
RV infarct - hypotension, clear lungs, increased JVP
Shock trial showed
Mortality benefit to PCI or CABG compared to Med rx for MI and cardiogenic shock, esp for those <75 yo
ICD indication after MI
Sustained VT or VF AFTER 48 hrs post PCI or reperfusion