In-Reply-To: <[log in to unmask]>
There are classically three components to making a diagnosis of
infarction, and your posting fails to identify two of those; pain and
enzyme rises. You are therefore treating on inadequate evidence. There are
several causes for an acute infarction pattern and I (although I have no
ageist views, and indeed would get little to do where I work if I did)
would be very hesitant to treat without better confirmation.
In this sort of situation echo would be extremely useful. It would allow
you to identify any ventricular wall dilatation and dyskinesia and give
you an idea of what her ejection fraction was like which would all help
with decision making. Valuable information (given her previous CVA) on the
presence of adherent ventricular clot (if indeed she had suffered
infarction) would also be gained.
Did she have an enzyme rise? Did the ECG changes resolve after treatment?
Best wishes,
Rowley Cottingham
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