Post AMI risk stratification

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%.