STEMI

Vital signs:

PE:

ECG:

TTE: EF, RWMA, no root dilatation/flap/AR, no pericardial effusion

CXR: 

Lab: LA, TnT

. Loading DAPT (aspirin 300mg + brilinta 180mg)
. Heparinization (Loading dose 60U/kg, max 4000U, maintenance dose 12U/kg/hr)
. Primary PCI then CCU admission
. f/u ECG and TnT Q6H until peaking
. Inform MACE and bleeding risk

. Check 4 limb BP for complaining back pain
. Risk stratification: check lipid profile, HbA1c, lipoprotein (a)
. Optimize medical therapy including beta blocker, ACEI/ARB and high intensity statin as tolerated

[PE]

E4V5M6

HEENT: Pink conjunctiva, anicteric sclera

Heart: Regular heart beat without murmur

Chest: bilateral clear breath sounds

Abdomen: Soft and flat, normoactive bowel sounds

Extremities: No pitting edema

Skin: no ecchymoses. no rash

[CAD Risk factors]

DM(-), Hypertension(-), Dyslipidemia(-), Smoking(-), Sex(-), Age>45(men)(-), Age>55(woman or postmenopause)(-), Family history(male<55, female<65), Lack of exercise(-), obesity (-), Gout (-)