Patient case study - Patient with acute myocardial infarction
Patient case study - Patient with acute myocardial infarction
This interactive module explores the care of a patient whose T2D was diagnosed after an acute myocardial infarction. Further management of T2D after hospital discharge is also discussed.
Patient case study - Patient with acute myocardial infarction
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How to use this case study
Mohammed
Admission to the ER
Initial management in the ER
Further investigations
Diagnosing T2D after acute STEMI
Diagnosing T2D after acute STEMI
Diagnosing T2D after acute STEMI
Suspicion for T2D on presentation with an acute STEMI
Suspicion for T2D on presentation with an acute STEMI
Previously unknown diabetes in patients presenting with acute MI is under-recognised and undertreated
Mohammed’s blood test results
Mohammed’s blood test results
Mohammed’s results suggest that he has T2D
Discussion with Mohammed
Having diabetes and prior MI is associated with a near 4-fold increased risk of death compared with not having these conditions
First-line treatment approach for T2D
First-line treatment approach for T2D
First-line treatment approach for T2D
Confirming treatment approach for T2D
Target for glycaemic control
Target for glycaemic control
Discussion with Mohammed
Treatment prescribed at discharge
Discharge from hospital
Mohammed – 8 weeks later
Mohammed’s management plan for T2D
Mohammed’s management plan for T2D
Mohammed’s management plan for T2D
Mohammed’s management plan for T2D
Mohammed’s management plan for T2D
ESC guidelines recommend glucose‑lowering therapies with proven CV benefit in patients with ASCVD or very high/high CV risk
ESC guidelines recommend glucose‑lowering therapies in patients with diabetes at very high CV risk and HF risk
ADA standards recognise HF as an important type of CV disease to consider when determining optimal T2D treatment
ADA recommends the use of an SGLT2 inhibitor or GLP-1 RA to reduce the risk of CV events or CKD progression
The 2020 ACC ECDP discusses opportunities to initiate SGLT2 inhibitors or GLP-1 RAs with demonstrated CV or kidney benefits in patients with T2D
The 2020 ACC ECDP recommends the use of SGLT2 inhibitors or GLP-1 RAs with proven CV benefit in conjunction with guideline-directed medical therapy
The 2020 ACC ECDP discusses using an SGLT2 inhibitor to manage patients with T2D at risk of developing ASCVD, HF and DKD
Discussion
Mohammed – patient case learning points
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