Chest pain characteristic
1 Substernal chest discomfort with a characteristic quality and duration
2 Provoked by exertion or emotional stress
3 Relieved by rest or nitroglycerine
Meets 3/3 = typical angina, Meets 2/3 = atypical angina, Meets 0-1/3 = noncardiac chest pain
Careful of atypical presentation especially in elderly, woman, diabetic patients
Beware of subtle STEMI
Oxygen supplementation only if Oxygen saturation 75 year-old that will received fibrinolytic agent give ASA gr. v 1tab, plavix 1 tab, in other cases ASA gr v 1 tab plavix 4 tab
120 minutes is time that determine primary PCI or fibrinolytic agent
4 extremities blood pressure and cardiac ultrasound before Fibrinolytic agent to look for Aortic dissection
Don’t forget pain control
Don’t forget to treat heart failure
Accelerated idioventricular rhythm(AIVR) is a good sign of reperfusion
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