Judge for yourself the management of this patient with " NSTEMI, multivessel disease "

DISCUSSION:The administration of
opioid analgesia prior to cath in patients with concern for ACS is associated
with longer door-to-balloon times, and greater peak troponin levels. The rate
of Occlusion MI in those who received pre-cath opioids was double the rate of
those without pre-cath opioids, and STEMI(-) OMI patients who received pre-cath
opioids waited 10 hours on average longer to get cath than those who did not
received opioids. These results add support to our hypothesis that a major
mechanism of harm caused by opioid medications in ACS patients involves delays
to the cath lab for patients with STEMI(-) OMI.===================================MY Comment, by KEN GRAUER, MD (9/5/2023):===================================Today ' s case illustrates a series of instructive teaching points. I focus my comments on Points of Interest that I ' ll add to Dr. Meyers ' excellent discussion.NOTE: We are told that the patient in today ' s case is man in his 50s who presented with new CP (Chest Pain)  — but whose prior medical history was remarkable only for hypertension — with mention of a " normal stress test " a few years earlier.Extra Credit: How does this patient ' s report of a " normal stress test " a few years earlier help us in our evaluation of this case?To facilitate taking another LOOK at the initial ECG in today ' s case — I ' ve l...

Source: Dr. Smith's ECG Blog - September 10, 2023 Category: Cardiology Authors: Pendell Source Type: blogs