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improvement
Acute Myocardial Infarction (AMI)
Last Update: October 2007 Contact: Cindy Feutz, RN, CS, M-SCNS Summary: A patient presenting to a hospital with chest pain and ST elevations on EKG may be a candidate for an immediate reperfusion strategy to prevent muscle loss due to the acute myocardial infarction. This may be done either with the IV administration of a thrombolytic agent or by percutaneous transluminal coronary angioplasty (PTCA). The effectiveness of either strategy depends upon their delivery in a timely fashion. Literature on thrombolytics has established that the benefit of treatment in terms of mortality and preservation of cardiac function diminishes exponentially over the first few hours after the onset of symptoms. The performance goal is to administer IV thrombolytic within 30 minutes of patient arrival (when IV thrombolytic is the reperfusion strategy of choice). At hospitals where primary PTCA is an option, the decision needs to be made whether to administer IV thrombolytic or perform primary PTCA based upon the time to reperfusion (the performance goal is 90 minutes). Since more timely intervention in the treatment of acute myocardial infarction (AMI) patients has been shown to reduce complications, length of stay and the overall cost of treatment may potentially decrease. Longer-term health outcomes, in terms of mortality, cardiac function and work capacity have all been shown to improve with swift intervention.
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