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Implementing and tracking quality improvement (QI) metrics may lead to improved outcomes in patientcare after STEMI in low- and middle-income countries (LMIC), according to an analysis of data from the ACC's Global Heart Attack Treatment Initiative (GHATI).
STEMI remains a major cause of morbidity, mortality, disability, and high health care costs in Latin America and the rest of the world. New data assessing the impact of ACC's Global Heart Attack Initiative (GHATI) on patientcare outcomes at the CEDIMAT Cardiovascular Center in Santo Domingo, Dominican Republic.
7, 2024 — The Society for Cardiovascular Angiography & Interventions (SCAI) recently announced the publication of the Expert Consensus Statement on the Management of Patients with STEMI Referred for Primary PCI. tim.hodson Mon, 10/07/2024 - 14:45 Oct.
But in actual practice, similar patients are routinely missed and under-treated, as you will see as this case progresses. mm in just one lead V7-9), but as far as I can tell all of these documents specifically avoid calling this condition STEMI and specifically avoid using any terminology similar to "STEMI equivalent."
1-3] But these studies were very short duration and used cardiology interpretation of ECGs or emergent angiography rather than patient outcomes. 4,5] We have now formally studied this question: Emergency department Code STEMIpatients with initial electrocardiogram labeled ‘normal’ by computer interpretation: a 7-year retrospective review.[6]
The possibility of anterior STEMI was not noticed during patientcare. Therefore, she underwent angiography and had a 95% LAD thrombotic culprit that, fortunately, had reperfused on its own (that's why the troponin was only 12). It was stented. I noticed it much later on looking through a random stack of EKGs.
The paramedics found the patient with ROSC and a GCS 7, and an ECG showing LBBB with possible lateral ST elevation. The patient was brought to the ED as a possible Code STEMI and was seen directly by cardiology. On arrival, GCS was 13 and the patient complained of ongoing chest pain. Learning points 1.
Even before we have clinical context, this ECG simply does not appear concerning for OMI, notwithstanding the machine's interpretation ** ** ACUTE MI / STEMI ** **. But in the world of STEMI, this is a challenging ECG to most. The patient ruled out for MI with serial troponin testing.
His first EKG is shown below, with a lead II rhythm strip: EKG 1, 1645 A provisder who is looking for STEMI would not see much in this EKG. I interpret this as manifesting active inferior OMI, although the patient's improving pain suggests at least some reperfusion. Patient has 4.5/10 10 chest pain. So he needs the cath lab.
It is a long read, meant only for those who want to know the hidden intricacies in the concept of “Time window” in STEMI and its important Implication in patientcare. [08/11, This is a transcript of one such conversation with an AI engine Llama 3.2
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