A patient present with acute anterior wall infarction and hyotension. Which will be the immediate treatment modality for this atient :
Answer is a D (Primary angioplasty) Immediate coronary angiography and primary percutaneous intervention (angioplasty stenting) is the treatment of choice for patient of ST elevation MI presenting within the first 12 hours of MI. The question does not provide us with sufficient information to determine best strategy of management. Presuming all ourable factors, primary percutaneous intervention with angiography and angioplasty is the single best answer of choice. Treatment of ST elevation Acute MI : Thrombolysis vs PCI The current recommendation is to Treat with Reperfusion Therapy either primary percutaneous Coronary Intervention of Thrombolytic therapy. Immediate coronary angiography and primary PCI of the infarct related aery is shown to be superior to thrombolysis provided it is performed by experienced operators in high volume centres. Primary PCI is also the treatment of choice in patients with absolute and many relative contraindications to thrombolysis. In the subgroup of patients with Cardiogenic Shock Primary PCI is the preferred management. The patient in question has an acute anterior wall infarction along and is presenting with hypotension (? Cordiogenic shock). Angiography will primary PCI (Angiopathy) is the recommended /ideal immediate nodality of treatment.
Intra aoic balloon counter pulsation
Anticoagulation
Thrombolytic therapy
Primary antioplasty