Guidelines are meant for simplifying cardiologist’s life as well as ameliorating patient suffering . It should also ensure improving overall outcome with efficient use of human resources and economy .
These guidelines are written from sophisticated centers mainly for consumption in developed countries .Though core concepts will be same , many recommendations are neither possible nor desirable at the exact point of delivery in less developed countries . Please remember these guidelines are not binding on you .Physician discretion is the ultimate principle in medicine.
So , let us read these guidelines apply our mind and try to indigenise . Get maximum out of it for the respective population .
Some of the highlights in this 2013 guidelines
1. Therapeutic hypothermia should be started as soon as possible in comatose patients with STEMI and out-of-hospital cardiac arrest caused by ventricular fibrillation or pulseless ventricular tachycardia, including patients who undergo primary PCI.31–33
(Level of Evidence: B)
2 . Presumed or New onset LBBB is no longer a Indication for emergency reperfusion
3 . Indication of Primary PCI has the following modification