FIELD: medicine.
SUBSTANCE: allocate clinical and laboratory and instrumental parameters in patients with acute myocardial infarction with a rise in the segment of St: preservation/absence of pain in the heart after thrombolytic therapy, ST segment on the ECG after 60-90 minutes after thrombolytic therapy, level of consciousness, necessity In artificial ventilation (AV), the degree of acute heart failure by Killip, the presence of heart rhythm disturbances, the presence of large bleeding, the level of creatinine. If the pain in the heart area is maintained, there is no decrease in the ST segment on the ECG by 50% or more from the baseline level after 60-90 minutes from the onset of thrombolytic therapy, absence of coma, no need for ventilation, absence of pulmonary edema (Killip 3), absence of cardiogenic shock (Killip 4), the absence of severe brady- and tachyarrhythmias, the absence of continuing large bleeding, the presence of any level of creatinine in the blood, decide to perform CCI in the shortest possible time. When the pain syndrome in the heart area is reduced, the ST segment falls on the ECG by 50% or more from the baseline level 60-90 minutes after the onset of thrombolytic therapy, absence of coma, no need for ventilation, absence of pulmonary edema (Killip 3), absence of cardiogenic shock (Killip 4), absence of pronounced brady- and tachyarrhythmias, absence of continuing large bleeding, creatinine level in the blood of not more than 200 mcmol/l make the decision to conduct an intervention within 3-24 hours after thrombolytic therapy. When coma, the need for mechanical ventilation, the pulmonary edema (Killip 3), cardiogenic shock (Killip 4), severe brady- and tachyarrhythmias, continued large bleeding, with a creatinine level in the blood of more than 200 mcmol/l if the pain syndrome in the region of the heart and reduction of the ST segment on the ECG by 50% or more from the baseline level after 60-90 minutes from the onset of thrombolytic therapy make a decision about conservative treatment of the patient.
EFFECT: method allows you to determine the timing and the possibility of transferring each individual patient with acute coronary syndrome and ST segment elevation after thrombolytic therapy to perform CCI.
3 ex
