Total Occlusion Late after Myocardial Infarction

It is well established the prompt reperfusion therapy within the first six hours of MI symptom onset can significantly reduce mortality and morbidity after MI, and reperfusion therapy with PCI/stenting or fibrinolysis is well established. However, it is not uncommon that a patient will undergo coronary angiography 12 or even 24 hours after MI, where a totally occluded artery is identified at that point in time. We present a case of such a patient and review a classic clinical trial that addresses this clinical situation.

You will learn:

  • To identify patients who present at later time points when reperfusion therapy is less well established
  • To enumerate patient-specific considerations when considering PCI in patients presenting late after MI
  • To appropriately apply the results of a classic clinical trial relating to this situation
  • To consider the appropriate clinical guidelines as they apply to patients presenting late after MI

Author(s): Lawrence Gimple, MD

Estimated time to complete: 15 minutes

Credit hours: .25

Method and Medium: Learners participate in the interactive learning modules by correctly answering multiple choice questions dispersed throughout. Learners will be prompted to try again if a question is answered incorrectly.