ST Elevation MI (STEMI) - Cardiac (non-arrest)

Question 1

Fibrinolytic therapy should be administered to a STEMI+ patient if the time from a non-PCI centre to a PCI-capable hospital exceeds what time?

Answer 1

Administer fibrinolytics if time to PCI >120 minutes

Question 2

What is the goal in minutes for PCI from first medical contact? How long from first medical contact to PCI if a patient was first taken to a non-PCI capable hospital?

Answer 2

<90 minutes from first contact to initiation of PCI at a capable hospital
<120 minutes from first contact to a PCI-capable hospital if pt first taken to a non-PCI capable hospital

Question 3

Although primary PCI is preferred in STEMI+ patients, how long can a patient recieve fibrinolytic therapy after onset if still STEMI+ and showing signs of ongoing ischemia.

Answer 3

Reperfusion therapy is reasonable for onset between 12 and 24 hours prior

Question 4

How long should a hospital wait to perform angiography after fibrinolytic therapy?

Answer 4

Within 24 hours, but not within the first 2-3 hours of fibrinolytics

Question 5

What are the ECG criteria required to diagnose a STEMI?

Answer 5

New ST elevation at the J-point in 2 contiguous leads:
>1mm in all leads EXCEPT
V2-V3 where >2mm in men >40 yo
V2-V3 where >2.5mm in men <40 yo
V2-V3 where >1.5mm in women regardless of age