Question

A pt's 12-lead ECG is transmitted by the paramedics and shows a STEMI. When the pt arrives in the ER, the rhythm shown here is sen on the cardiac monitor. The pt has resolution of moderate (5/10) CP after 3 doses of sublingual nitroglycerin. BP is 104/70 mmHg. Which intervention is most important in reducing this pts in-hospital and 30-day mortality rate?

Answer 1

Reperfusion therapy, specifically thrombolytic therapy or percutaneous coronary intervention, is the most important intervention to reduce in-hospital and 30-day mortality following a STEMI.

Step-by-step explanation:

The most important intervention for reducing a patient's in-hospital and 30-day mortality rate after confirmation of a ST-elevated myocardial infarction (STEMI) on a 12-lead ECG is rapid and appropriate reperfusion therapy. This typically involves the administration of thrombolytic agents to dissolve blood clots or performing a percutaneous coronary intervention (PCI), commonly known as balloon angioplasty and stenting. The goal is to restore blood flow to the affected area of the heart as quickly as possible to limit damage to the myocardial tissue.

Initial measures such as the administration of supplemental oxygen, aspirin, and nitroglycerin play a crucial role in stabilizing the patient and mitigating symptoms, but they do not replace the need for reperfusion therapy. In cases where a patient has significant, extensive damage or for whom reperfusion therapy is not enough, more invasive procedures like coronary artery bypass graft surgery (CABG) or the implantation of a coronary assist device might be considered.