[HSF] Sympathy anyone.......

[Ani Anyanwu]

I am not sure I see this as one of our usual cath lab horrors.
 
Are tall, thin and long fingered patients not entitled to have myocardial infarcts? ST elevation, enzyme rise and chest pain, regardless of habitus of patient, = myocardial ischemia or infarct until proven otherwise. A four day history moreso will push most doctors to a diagnosis of acute coronary syndrome - even if there are truly marfanoid features - as in the emergency medical cookbook, dissection is an acute presentation and not a four day one. 
 
I suspect the\is patient would have been managed the same way in many other western medical centers worldwide. I also suspect there are numerous other tall thin patients who suffer myocardial infarcts and are thrombolysed or have primary PCI every year that we do not get to hear of or criticize.
 
Ani
 
 



> From: donross at bigpond.com> Subject: Re: [HSF] Sympathy anyone.......> Date: Thu, 1 May 2008 18:34:18 +1000> To: OpenHeart-L at lists.hsforum.com> CC: > > Cards are a class act!> On 01/05/2008, at 11:26 AM, Michael Firstenberg wrote:> > > 51 year/old.....presented with 4 day history of chest pain.> > Tall, thin, long fingers....> > ST changes on ECG.> > Concern for AMI> > Given:> > ASA> > High dose Plavix> > Lovenox> >> > taken to cath lab> >> > found to have Type A dissection from valvue to iliacs........> >> >> > oh, he also got reopro............> >> >> > it has been a long day.> >> >> > -michael> > _______________________________________________> > OpenHeart-L mailing list> >> > Send postings to:> > OpenHeart-L at lists.hsforum.com> >> > To UNSUBSCRIBE, to CHANGE email address, or to view archives:> > http://mmp.cjp.com/mailman/listinfo/openheart-l> >> > All messages transmitted by the OpenHeart-L are subject to the > > policies and> > disclaimers posted at:> > http://www.hsforum.com/listdisclaim> > -----------------------------------------> > _______________________________________________> OpenHeart-L mailing list> > Send postings to:> OpenHeart-L at lists.hsforum.com> > To UNSUBSCRIBE, to CHANGE email address, or to view archives:> http://mmp.cjp.com/mailman/listinfo/openheart-l> > All messages transmitted by the OpenHeart-L are subject to the policies and > disclaimers posted at:> http://www.hsforum.com/listdisclaim> -----------------------------------------
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