Case 1:

JF is a 42-year old previously healthy farmer who presented with sudden onset central chest pain of one hour duration to the ED. The pain is associated with sweating and radiates to the left arm and jaw. The area of discomfort is about the size of the fist.

Ragavendra R. Baliga, M.D
Assistant Professor
Division of Cardiology
University Of Michigan

 

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Question 16 of 39:

Since this patient is below 60 years old primary percutaneous coronary angioplasty (PTCA) is preferred to thrombolysis.

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There are no trials or empiric data substantiating better outcome using this approach. A conservative strategy of risk stratification and a more selective use of procedures may be more cost-effective with revascularization less frequently performed and targeted to those who benefit from it.

There is serious concern that a routine policy of primary PTCA for patients with acute MI will result in unacceptable delays in achieving reperfusion in a substantial number of cases and less than optimal outcomes if performed by less experienced operators.

 
 
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