40 year old male patient presents to the Emergency depament with central chest pain for 2 hours. The ECG shows ST segment depression and cardiac troponins are elevated. Patient has a positive history of previous PCI 3 months back. He is administered Aspirin, Clopidogrel, Nitrates and LMWH, in the Emergency Depament and shifted to the coronary are unit. The best recommended course of fuher action should include.
Answer is B (Early Revascularization with PCI) The patient presenting as a case of NSTE M I to the emergency depament. The presence of elevated cardiac troponins and history of previous PCI place the patient into a high 'risk category'. The Patient in question is th 10 a 'high risk' patient with NSTEMI Such patients are candidates for early invasive management with PCl/CABG.
Immediate Revascularization with Thrombolytics
Early Revascularization with PCI
Continue conservative management and monitoring of cardiac enzymes and ECG
Continue conservation management and plan for delayed Revascularization procedure after patient is discharged