7 steps for success in managing Acute MI in COVID 19 era?
Myocardial Infarction (MI) is of two types – STE elevation MI (STEMI) and non-ST elevation MI (NSTEMI)
STEMI patients are best managed by Primary Angioplasty and stent procedure where ever cath lab facilities are available
When cath lab is not available – pharmaco-invasive strategy is preferred – i.e.; thrombolyze as soon as possible and then transfer to cath lab center after initial stabilization. Angioplasty to be done within 24 hours of onset of chest pain.
NSTEMI is best managed medically at least initially and further management based on GRACE score
High GRACE score - Early angiography and revascularization
Low GRACE score - medical management
Cardiologists need to realize that COVID can masquerade as AMI and also differentiate myocarditis from AMI
Clinicians need to protect their staff by imparting knowledge as well availability of appropriate PPE in cath lab
Public should be educated not to ignore symptoms of heart attack and the need for timely reperfusion needs need to be emphasized.