By Jason N Katz; Chetan B Patel; M Kamran Aslam; Parkland Memorial Hospital (Dallas, Tex.); University of Texas Southwestern Medical School at Dallas
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A. Davis. A. Davis. A. Davis. A. Davis. A. Davis. A. Davis. A. Davis. A. Davis. A. Davis. A. Davis. A. Davis. A. Davis. Acute Coronary Syndromes and Risk Stratification 25 • Mechanical complications of acute MI (see section titled Complications Following Myocardial Infarction) • Cardiogenic shock (see section titled Complications Following Myocardial Infarction) Patient Care Warnings • Beware of post-MI angina • Check posterior leads with ST-segment depressions in V1-3 to rule out true posterior ST-segment elevations • Avoid nitrates and diuretics in patients with right-sided myocardial infarctions; fluids may be useful • Be cautious with beta blockers in patients with decompensated heart failure in the setting of MI; may consider esmolol as a test dose • Therapy in STEMI should not wait for the results of serum biomarkers • Does your patient have aspirin References ➌ 1.
Bedside diagnosis of the acute myocardial infarction and its complications. Curr Prob Cardiol 1982;7:1-86. ➊ 2. Crimm A, Severance H, Coffey K, et al. Prognostic significance of isolated sinus tachycardia during first three days of acute myocardial infarction. Am J Med 1984;76:983-88.
A. Davis. 38 Chapter 1 • CARDIOLOGY ated and resulted in reduced echocardiographic thrombus size at a mean follow-up of 13 days48 • Cardiogenic shock: see section titled Congestive Heart Failure and Systolic Dysfunction • General principles of AMI management apply in cardiogenic shock: aspirin, heparin, and glycoprotein IIB/IIIA inhibitors; special attention should be given to tissue perfusion, which can be augmented by inotropes and vasopressors • IABP: improves coronary perfusion and reduces myocardial workload and therefore ischemia (see section titled Intra-Aortic Balloon Pumps).