Myocardial infarction: Difference between revisions
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*I have seen quite a few type 2 MI's and our database really does not deal with this. A type 2 MI is when there is no evidence of coronary artery disease, but the MI still occurs for other reasons. It occurs when there is supply/demand mismatch with no CAD. The most common one we see is related to prolonged anemia where the pt's oxygen-carrying capacity is reduced. Another reason would be reduced blood volume (hypovolemia), profound bradycardia, etc. These conditions can cause an MI even with normal coronary arteries. | *I have seen quite a few type 2 MI's and our database really does not deal with this. A type 2 MI is when there is no evidence of coronary artery disease, but the MI still occurs for other reasons. It occurs when there is supply/demand mismatch with no CAD. The most common one we see is related to prolonged anemia where the pt's oxygen-carrying capacity is reduced. Another reason would be reduced blood volume (hypovolemia), profound bradycardia, etc. These conditions can cause an MI even with normal coronary arteries. | ||
* I propose that if there is a supply/demand mismatch with normal coronaries and there is an elevated troponin, we call in a non Q MI (NSTEMI)unless there is a clear diagnosis of a STEMI or other reason for an increased troponin. The other option is to make a new category for type 2 MI.--[[User:LKolesar|LKolesar]] 14:38, 2015 November 16 (CST) | * I propose that if there is a supply/demand mismatch with normal coronaries and there is an elevated troponin, we call in a non Q MI (NSTEMI)unless there is a clear diagnosis of a STEMI or other reason for an increased troponin. The other option is to make a new category for type 2 MI.--[[User:LKolesar|LKolesar]] 14:38, 2015 November 16 (CST) | ||
* I don't think this is new...we recognize this in the ACS population...if angio isn't done coronary arteries/status would not be known but we still code as NSTEMI(reviewing the EKGs and cardiology consult notes) and have been for awhile.--[[User:Llemoine|Llemoine]] 14:47, 2015 November 16 (CST) | |||
== Discussion - elimination of subcodes == | == Discussion - elimination of subcodes == | ||