Fellow, Structural Heart Disease, St. Michael’s Hospital. Interventional Cardiologist, SAH. IC in a nutshell: ‘If it’s closed, open it. If it’s open, close it.’
Aug 3, 2021 • 8 tweets • 8 min read
@EM_VATA@JdBapttiste@bwoody58@dr_benoy_n_shah Learning points: 1) ongoing pain is a MAJOR red flag, regardless of ECG. Cath immediately without delay. 2) Q waves do NOT mean non-viable myocardium. They can develop early during ischemia. 3) Hypokinesis/akinesis does NOT imply that the myocardium is non-viable
@EM_VATA@JdBapttiste@bwoody58@dr_benoy_n_shah 4) It takes ischemia of only 20% of wall thickness to generate a wall motion abnormality on echo. 5) There is nothing to gain and everything to lose by sitting on such a patient and delaying cath. 6) Beware opiates given to such patients which can mask pain. Use nitro first.
