Image Based Question – 74509

A 76 years old male patient presents to the AIIMS emergency with retrosternal chest pain for 6 hours. The following EKG was taken. What will be your primary management?

A. Primary PCI

B. Thrombolysis

C. Abciximab

D. Low molecular weight heparin

Correct Answer » D Explanation

Ans: D. Low molecular weight heparin

(Ref: Harrison 19/e p1597, 18/e p2020)

• EKG in this scenario is showing T-wave inversion (Leads I , aVR , aVL) with a history of retrosternal pain for 6 hours.
• This is suggestive of Non-ST elevation MI.
• The primary management of NSTEMI is anti- thrombotic therapy followed by early PCI, if high-risk features are present.
• In this patient, there are no ST wave changes or any other high-risk feature mentioned.
• Hence low molecular weight heparin should be the treatment of choice.