A working description for severe developing myocardial infarction in the existence of clinically suitable symptoms continues to be established as individuals with ST segment elevation, i.e. New ST segment elevation in the J stage with the take off points 0.2mV in V1through V3and 0.1mV in other leads, or individuals without ST segment elevation, i.e. ST segment depression or T wave problems. The present recommendations pertain to patients presenting with ischemic symptoms and persistent ST segment height on the ECG. A large proportion of these patients will show an average rise of biomarkers of myocardial necrosis and progressto Q wave myocardial infarction.
At the latest European Heart Survey, mortality in patients presenting with ST segment height acute coronary syndromes was 8.4 percent at 1 month. Whilst the main concern of doctors is to prevent death, these looking after victims of myocardial infarction objective to minimize the patient’s suffering and distress as well as to restrict the extent of myocardial damage. Myocardial perfusion scintigraphy in addition has been successfully used, though unfrequently, in the triage of patients presenting with severe chest pain.19, 20 A regular resting technetium 99m myocardial perfusion scintigram economically excludes serious myocardial infarction. Pre hospital or early in hospital care Restoring coronary flow and myocardial tissue reperfusion For individuals with the clinical demonstration of myocardial infarction and with continual ST segment height or new or presumed new left bundle branch block, early physical or pharmacological reperfusion must be done unless clearcontraindications are present. In accordance with the Fibrinolytic Therapy Trialists analysis for all these presenting within 6h of symptom onset, arid ST segment height or bundle branch block, roughly 30 deaths are prevented per one thousand patients treated, with 20 deaths prevented per one thousand patients treated for all those between 7 and 12h. Beyond 12h there’s no convincing proof of advantage for the group as a whole.
22 Two latest registry type studies36, 37 questioned the advantage of fibrinolytic therapy in older people, with one of those studies even suggesting more bad than good.36 Nevertheless, a latest re analysis by the FTT secretariat suggests that in about 3300 individuals over the age of 75 presenting within 12h of symptom onset and with either ST segment height or bundle branch block, mortality rates were significantly reduced by fibrinolytic therapy.