Recently a 65-year-old male consulted a cardiac centre and ECG showed ST-T changes in inferior leads. The cardiologist took an echo and reported it as normal. That was the end of workup for inferior lead changes. No TMT was ordered. This happened in Sep 2019. The patient recently came to a casualty with chest pain and typical ST elevation of acute IWMI noted with Trop I negative. Because Trop I negative no loading dose was given by the CMO immediately.
The patient waited for my opinion for two to three hours in OPD. Then I referred the patient for ICU care. The case gives certain points of fit-falls in cardiac care even in a cardiac centre. A case with ECG changes should be explored to the fullest extent with TMT as well as lipid work up. Drugs should have been at-least prescribed for CAHD. Don’t decide on Trop I result alone when there is a definite change in favour of AMI. Fortunately…
