Best treatment?

Cardiology

A patient has ongoing pain and has ECG changes that are considered “thrombolysable”. Based on the available evidence what is the best treatment for her?

  • Thrombolyse immediately
  • Emergency Angiography +/- +/- plasty/stent *
  • Either Thrombolysis or emergency angiography+/- plasty/ stent have almost identical outcomes
  • Emergency Coronary artery Bypass Graft
  • None of the above

Emergency Angiography +/- +/- plasty/stent.

In centres with available facilities emergency PCI (percutaneous coronary intervention) is the gold standard treatment of choice. It has a survival advantage over thrombolysis although this is only small it is significant.