Anterior Ischemia

ICU_floater · Mar 5, 2007

google left main, LCA blockage.... This can be unfortunately minor as far as symptoms, the pt. looses a percent of EF and can't tell, then the think this wasn't bad and becomes non compliant in their med regimend.

A LCA can cause severe stunning as well, temporary and the pt. is symptomatic with any activity and requires massive rehab after although not necessarily symptomatic in the initial MI... they're white, exhausted easily and look unwell. Then they perk up as the "stunning " goes away and their EF% improves and so do they.

The worst case of the left MI is the left ventricle is permanently damaged due to failed thrombolytics, lack of door to cath lab facilities and the damage is done and permanent. The EF% is now at a huge hit which can effect cardiac output, these frequently go into cardiogenic shock, require balloon pump therapy or inotropes such as dobutamine, primacor to decrease the afterload of the MI.

I've always said, give me an RV MI with the intractable nausea and vomiting which was minor and sooo symptomatic... you have easier compliance because they "suffered".... you're silent LV MI.... try getting buy in with a drop of EF 15 %, it's so much harder... because they never felt "sick" after the chest pain went away.

meandragonbrett · Mar 6, 2007

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