Цитата:
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Сообщение от dmblok
А есть ли критерии?
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Мне кажется, есть.
Цитата:
ACC/AHA Guidelines for the Management of Patients With ST-Elevation Myocardial Infarction
6.3.1.6.3.1. Indications for Fibrinolytic Therapy
Class I
1. In the absence of contraindications, fibrinolytic therapy should be administered to STEMI patients with symptom onset within the prior 12 hours and ST elevation greater than 0.1 mV in at least 2 contiguous precordial leads or at least 2 adjacent limb leads. (Level of Evidence: A)
2. In the absence of contraindications, fibrinolytic therapy should be administered to STEMI patients with symptom onset within the prior 12 hours and new or presumably new LBBB. (Level of Evidence: A)
Class IIa
1. In the absence of contraindications, it is reasonable to administer fibrinolytic therapy to STEMI patients with symptom onset within the prior 12 hours and 12-lead ECG findings consistent with a true posterior MI. (Level of Evidence: C)
2. In the absence of contraindications, it is reasonable to administer fibrinolytic therapy to patients with symptoms of STEMI beginning within the prior 12 to 24 hours who have continuing ischemic symptoms and ST elevation greater than 0.1 mV in at least 2 contiguous
precordial leads or at least 2 adjacent limb leads. (Level of Evidence: B)
Class III
1. Fibrinolytic therapy should not be administered to asymptomatic patients whose initial symptoms of STEMI began more than 24 hours earlier. (Level of Evidence: C)
2. Fibrinolytic therapy should not be administered to patients whose 12-lead ECG shows only ST-segment depression except if a true posterior MI is suspected. (Level of Evidence: A)
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Во-первых, мне при том разрешении, которое дает мой монитор, кажется, что в II, III, aVF, V6 есть подъем более, чем на 1 мм. Во-вторых, показание IIа - "True posterior MI may be manifested by tall R waves in the right precordial leads and ST-segment depression in leads V1 through V4".
Хотя, если ангиография через 2 часа таки будет доступна, наверно, я присоединюсь к Михаилу Юрьевичу.