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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Chest Pain, Has Stent, Possible Acute MI. Take To Advanced Care?

Hi. a 60yr old male with history of 3 x CABG and one stent (done 13 yrs ago) and uncontroled DM type 2. He had severe chestpain 1/52 ago, but didn t seek medical attention at the time. today he presented with chest discomfort only. Cardiac panel done: CKMB pos, Tnl pos, Myo neg. Streptokinase was not done with the latter presentation. inf post MI was diagnosed. By monitoring the patient s 12 lead, how would I be able to identify ACUTE MI, given that it may be silent ? What changes can I expect, should the patient have another MI before I could get him to more advanced care?
posted on Sat, 2 Feb 2013
Twitter Sat, 2 Feb 2013 Answered on
Twitter Mon, 4 Feb 2013 Last reviewed on
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General & Family Physician,  's  Response
Thank you for your questions . Diagnosis of acute MI needs changing pattern of cardiac biomarkers plus ECGs along with ischaemic symptoms. Diagnosing acute MI is a big picture where ECG plays an very important role. ST-T changes, appearance of Pathological Q wave, New LBBB etc will help you to diagnose acute MI. Changing pattern i.e. rise and or fall of biomarkers is a must for diagnosing or excluding acute MI. Hope you got your answers.
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Chest Pain, Has Stent, Possible Acute MI. Take To Advanced Care?

Thank you for your questions . Diagnosis of acute MI needs changing pattern of cardiac biomarkers plus ECGs along with ischaemic symptoms. Diagnosing acute MI is a big picture where ECG plays an very important role. ST-T changes, appearance of Pathological Q wave, New LBBB etc will help you to diagnose acute MI. Changing pattern i.e. rise and or fall of biomarkers is a must for diagnosing or excluding acute MI. Hope you got your answers.