First make the diagnosis:
It should still be based on 2 out of the 3 criteria:
Chest pain > 10-20 mins
ECG changes
Enzyme changes
Once the diagnosis is made, then decide if evidence
shows thrombolysis to be beneficial, ie st elevation
or new LBBB.
I dont think I could have made the diagnosis of an AMI
so I also would not have thrombolysed.
In the end I feel he had an elective CABG for
non-threatening (at that point), coronary occlusions.
Elective surgery often has better results, so you did
him a favour!!!
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