Уважаемые кардиологи, помогите разобраться. Вопрос о реинфаркте на 5-е сутки. Разве на 5-е сутки говорят о реинфаркте?
Источник: CASE FILES: Internal medicine third edition. Eugene C. Toy, John T.Patlan. Copyright © 2009.
A 59-year-old diabetic woman had suffered an acute anterior wall MI.Five days later, she gets into an argument with her husband and complains of chest pain. Her initial ECG shows no ischemic changes, but serum cardiac troponin I levels are drawn and return mildly elevated at this time. Which of the following is the best next step?
A. Thrombolytic therapy.
B. Percutaneous coronary intervention.
C. Coronary artery bypass.
D. Perform serial ECGs and obtain CK-MB.
E. Prepare the patient for dialysis.
ANSWER
D. Diabetic patients can have myocardial ischemia or infarction with atypical or absent symptoms. Clinical suspicion is required, and a liberal use of cardiac enzymes. Troponin levels often remain elevated for 7 to 10 days and should not be used to diagnose
reinfarction, especially if the levels are trending downward. New ECG findings or rapidly rising markers such as serum myoglobin or CK-MB can be used in this setting.
Я нашла только эту статью,
http://medgazeta.rusmedserv.com/2003...ticle_305.html но там о сроках кокретно не говорится.