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    Post AMI risk stratification

    Teaching Case

    Case presentation:

    • Female.
    • 71 y.o.
    • Anterior acute myocardial infarction (AMI).
    • Symptoms of heart failure, no chest pain.
    • Post MI risk stratification (pre-discharge).
    • Myocardial perfusion imaging with 99mTc / dipyridamole.

    Teaching points:

    • The aim of risk stratification in stable AMI survivors is to rapidly identify high-risk patients who might benefit from cardiac revascularization, and low-risk patients for whom medical therapy and early hospital discharge is appropriate.
    • Revascularization does not improve outcome beyond medical therapy when there is minimal or no induced ischemia.
    • Post MI, relative risk for cardiac events significantly increases as LVEF decreases: An LVEF ≥50% predicts a 1- year event rate of 5%, which reaches 27% in patients with an LVEF <20%.

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