Narrative Review: Myocardial Infarction

Site:

AE:

Complication:

Event date:

Adverse event code:

• Demograghic: [age] year old [gender]
• Past Medical History: [eg. CAD, Severe mitral stenosis, former tobacco use, dyslipidemia, ...]
• Index Procedure Date/Time: xx/xx/xxxx at xx:xx [insert date and time]
• Index Procedure Detail:
  • On [insert date and time] the subject underwent a [select surgical correction] for [select etiology].
  • Enter access site details
  • Baseline MR severity was classified as [select none, trace, mild, mild-moderate, moderate, moderate-severe-severe] and post-implant MR was classified as [select severity].
  • The site reported that there were/were not procedural complication(s).
• Event: MI
• Site Reported Event Onset Date: xx/xx/xxxx
• Event summary:
  • Symptoms and sign: Subject presented with [sign and symptom] on xx/xx/xxxx. Important characteristics of the chief complaint such as severity, site, and duration. Important symptoms related to the chief compliant.
  • Physical assessment: Write positive physical examinations or related negative examinations
• Lab studies:
  • Troponin levels and timing:

Date		Time	CKMB nl: (ratio)	Troponin nl: (ratio)
xx/xx/xxx		xx:xx
xx/xx/xxx	xx:xx
xx/xx/xxx	xx:xx

• • Other labratory:
  • Date/ name/ value

• ECG’s:
  • Date/Findings:

• ECHO/ date:
  • Trans-thoracic:
  • Trans-esophagus:
• CXR/ date:
• Other imaging and diagnostic tests/ date:
• Clinical course:
• Treatment:
• Outcome: