1) what are the precursor risks for a heart attack?
2) I47yom reports to the office 2nd to acute CP (2nd visit to the office in a 2 week time period w/ chief complaint of CP--1st visit was told by primary "having muscle spasms in chest" tx'd with
an IM injection for pain in the office, prescribed Daypro and Muscle relaxor and sent home) and is evaluated by associate MD 2nd to the primary MD scheduled off for the day and EKG reveals pending AMI; associate calls the primary with detail findings and primary recommends sending pt to ER (told associate status was not going to be an emergency situation) for eval via car to a hospital 35-40 minutes away (does not specialize in AMI treatment) instead of prompting eval from the ER located across the street from the office (just seconds away) to find pt in active process of 2nd AMI when he arrives to the ER which prompts transfer to local Heart Institute Hosp via EMS, undergoes emergent Lt Heart Cath revealing 100% occlusion of LAD requring stenting using bare metal stent. What is your intake of the process of care handled in this case?
1. CAD risk factors such as elevated cholesterol, htn, smoking, DM, family history age and sex. Inflammation, as we now begin to understand, is a risk factor for having an MI. There are blood markers such as CRP or MPO that can test for that.
2. Given your age and your risk factors I would say that the initial doctor there did not handle this right, but i am not going to judge him. He may have had other reasons to go that route. Of course, you got the worst of it. As far as the transfer is concerned, it is better that you were moved to a more experienced heart center that can deal with MI's faster.
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