ECG with ST elevation, Low BP. Best line of management is-
Reperfusion therapy is a medical treatment to restore blood flow, either through or around, blocked aeries, typically after a hea attack (myocardial infarction (MI)). Reperfusion therapy includes drugs and surgery. The drugs are thrombolytics and fibrinolytics used in a process called thrombolysis an MI is presented with ECG evidence of an ST elevation known as STEMI, or if a bundle branch block is similarly presented, then reperfusion therapy is necessary. In the absence of an ST elevation, a non-ST elevation MI, known as an NSTEMI, or an unstable angina may be presumed (both of these are indistinguishable on initial evaluation of symptoms). ST elevations indicate a completely blocked aery needing immediate reperfusion. In NSTEMI the blood flow is present but limited by stenosis. In NSTEMI, thrombolytics must be avoided as there is no clear benefit of their use . If the condition stays stable a cardiac stress test may be offered, and if needed subsequent revascularization will be carried out to restore a normal blood flow. If the blood flow becomes unstable an urgent angioplasty may be required. In these unstable cases the use of thrombolytics is contraindicated. At least 10% of treated cases of STEMI do not develop necrosis of the hea muscle. A successful restoration of blood flow is known as aboing the hea attack. About 25% of STEMIs can be aboed if treated within the hour of symptoms onset Ref Davidson edition23rd pg 467
IABP
Vasopressors
Reperfusion
Thrombolytics
C.V.S