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For Primary PCI to be most effective . . . Do it before the Troponin appear in blood !

Posted Mar 09 2011 12:38pm

Is there a bio chemical way to measure time window in STEMI ?


It seems so. In this era of hyperacute PCIs  , we are supposed to diagnose STEMI very early .If you wait for troponin  to assit you in diagnosis it  implies  one has missed the golden hour already (At least Three  golden hours to be precise !)

Cardiac enzymes have a unique value in timing a STEMI as  time of   onset of  chest pain is   unrealiable

as the patient (Even the physician !)  may not be able to differentiate pre infarction angina from infarct pain.

In these situation cardiac enzymes provide us a clue.

The time of realse of these molecules are fairly predictable.

  • Myoglobin -2 -3hours
  • Troponin elvation -3 -6 hours
  • CPK -  8 -12hours

Remember  ECG  rarely show a  time lag   in diagnosing STEMI  !

Message

For  maximum benefit . . . try to perform the  primary PCI before the troponin  appear in blood .

Does this  sound a crazy   tip ? What to do . . . truths are very often crazy .


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