JACC. Case reports · 2025
Heart of the Rockies: STEMI With Thrombolytic Failure Complicated by Cardiogenic Shock in a Snowstorm.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Appareddy Nina Shyama, Khan Manaquibb S, Sood Divyanshi, Garcia Wallacy S, Aruni Bhavith B
Аннотация
BACKGROUND: Thrombolytic therapy is indicated for patients with ST-segment elevation myocardial infarction (STEMI) presenting >120 minutes from a percutaneous coronary intervention-capable facility. Timely transfer is critical in thrombolytic failure.
CASE SUMMARY: A 46-year-old woman presented to a rural emergency department with an anterior STEMI. Thrombolytics failed. Transfer was delayed because of a snowstorm. She arrived at our facility hours later in cardiogenic shock. She was treated with rescue percutaneous coronary intervention and initiation of mechanical circulatory support with a percutaneous transvalvular microaxial flow pump. She ultimately recovered and has done well on follow-up.
DISCUSSION: The patient presented to the emergency department promptly and was appropriately treated in a timely manner. However, geographic isolation and inclement weather posed insurmountable and potentially life-threatening delays in care.
TAKE-HOME MESSAGES: Rural-urban health disparities can complicate the STEMI pathway. Prompt recognition and treatment of thrombolytic failure and cardiogenic shock is critical to patient outcomes.
CASE SUMMARY: A 46-year-old woman presented to a rural emergency department with an anterior STEMI. Thrombolytics failed. Transfer was delayed because of a snowstorm. She arrived at our facility hours later in cardiogenic shock. She was treated with rescue percutaneous coronary intervention and initiation of mechanical circulatory support with a percutaneous transvalvular microaxial flow pump. She ultimately recovered and has done well on follow-up.
DISCUSSION: The patient presented to the emergency department promptly and was appropriately treated in a timely manner. However, geographic isolation and inclement weather posed insurmountable and potentially life-threatening delays in care.
TAKE-HOME MESSAGES: Rural-urban health disparities can complicate the STEMI pathway. Prompt recognition and treatment of thrombolytic failure and cardiogenic shock is critical to patient outcomes.