Acute Myocardial Infraction
- Myocardial Infarction (MI) is of two types – STE elevation MI (STEMI) and non-ST elevation MI (NSTEMI)
- STEMI patients are best managed by Primary Angioplasty and stent procedure where ever cath lab facilities are available
- When cath lab is not available – pharmaco-invasive strategy is preferred – i.e.; thrombolyze as soon as possible and then transfer to cath lab center after initial stabilization. Angioplasty to be done within 24 hours of onset of chest pain.
- NSTEMI is best managed medically at least initially and further management based on GRACE score
- High GRACE score – Early angiography and revascularization
- Low GRACE score – medical management
- Cardiologists need to realize that COVID can masquerade as AMI and also differentiate myocarditis from AMI
- Clinicians need to protect their staff by imparting knowledge as well availability of appropriate PPE in cath lab
- Public should be educated not to ignore symptoms of heart attack and the need for timely reperfusion needs need to be emphasized.