MI post heparin drip

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I took care of a patient who was on a heparin drip because of a pulmonary embolism. He came to our unit stable from the ICU. We took him off the heparin drip, and he seemed to be progressing well. When I came backthe next morning, however, i learned the had expired. the night shift RN told me he started to complain of chest pain, which didn't seem alarming at first since he had been coughing intermittently and had complained of pain when coughing. However the pain started to get worse. She got a 12-lead EKG and found out he was having an active STEMI. Rapid response was called, but the doctors decided not to take him to cath lab - instead they wanted to treat him pharmacologically only.He was transferred back to ICU and unfortunately didn't make it.i am trying to understand why he didn't go to cath lab. Is it because he was on the heparin drip just earlier that day?

Specializes in Quality, Cardiac Stepdown, MICU.

If your unit stopped his heparin drip, then his INR must have been therapeutic (Greater than 2.) Perhaps the MD didn't want to have to reverse him with Vitamin K and/or FFP, especially if they thought the PEs hadn't resolved. . .hmm. Interesting, please let us know if you find out!

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If your unit stopped his heparin drip, then his INR must have been therapeutic (Greater than 2.) Perhaps the MD didn't want to have to reverse him with Vitamin K and/or FFP, especially if they thought the PEs hadn't resolved. . .hmm. Interesting, please let us know if you find out!

Vitamin K and INR...heparin?

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Specializes in Quality, Cardiac Stepdown, MICU.
Vitamin K and INR...heparin?

No, Coumadin. I assume if the heparin drip was stopped, the pt was therapeutic on their coumadin and approaching discharge.

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