ACS protocol to be, or not to be






























One minute case: It's 3 am and you are called because a patient, known case of MI, just admitted with dengue fever, says he experienced left-sided chest pain unrelated to exertion this evening, but there's no chest pain at the moment. They send you a picture of the ECG strip and these lab values, while you're walking to evaluate the patient: Platelets 226, Trop-I 0.01, Repeat Trop-I 0.03.

You can tell them to live in the moment! Here's why:
Despite T wave inversions in this ECG, this dengue-inflicted patient's asymptomatic at the moment, and so we've decided against ACS protocol. 
But if patient complains of chest pain, YOU'VE TO administer oral aspirin and IV heparin, and observe. 


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