Management of Ischemic Heart Disease
Module A Algorithm - Suspected Acute Myocardial Infarction (ST-Elevation or LBBB)

Link Annotation A: Patient With Suspected Myocardial Infarction (MI), With ST-Segment Elevation Or New Or Old Left Bundle Branch Block (LBBB) Link Annotation D: Are There Alternative Catastrophic Diagnoses? Link Annotation B: Ensure Emergency Interventions Link Annotation C: Obtain Focused History And Physical Examination Link Annotation E: Initiate Medical Therapy. Link Annotation D: Are There Alternative Catastrophic Diagnoses? Link Annotation E: Initiate Medical Therapy Link Annotation F: Is It Less Than 12 Hours Since Onset Of Symptoms? Link Annotation G: Can Percutaneous Revascularization Be Accomplished Within 90 Minutes of Patient Presentation? Link Annotation H: Are There Contraindications To Thrombolysis? Link Annotation I: Initiate thrombolytic therapy for patients not referred to direct percutaneous revascularization. Link Annotation J: Is Patient Response Satisfactory? Link Annotation K: Are Ischemic Symptoms Still Present? Link: Continue to Page A2
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Link Annotation A: Patient With Suspected Myocardial Infarction (MI), With ST-Segment Elevation Or New Or Old Left Bundle Branch Block (LBBB) # Link Annotation D: Are There Alternative Catastrophic Diagnoses? #
Link Annotation B: Ensure Emergency Interventions #
Link Annotation C: Obtain Focused History And Physical Examination #
Link Annotation E: Initiate Medical Therapy. #
Link Annotation D: Are There Alternative Catastrophic Diagnoses? Evaluate and treat, as indicated. #
Link Annotation E: Initiate Medical Therapy # #
Link Annotation F: Is It Less Than 12 Hours Since Onset Of Symptoms? Link Annotation G: Can Percutaneous Revascularization Be Accomplished Within 90 Minutes of Patient Presentation? # #
# Assess for contraindications to thrombolysis. # #
Link Annotation H: Are There Contraindications To Thrombolysis? Refer urgently to interventional Cardiology. #
Link Annotation I: Initiate thrombolytic therapy for patients not referred to direct percutaneous revascularization. # #
Link Annotation J: Is Patient Response Satisfactory? # #
Link Annotation K: Are Ischemic Symptoms Still Present? Refer urgently to interventional Cardiology. Link: Continue to Page A2 #