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.]
- Other 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
- Other labratory:
- ECG’s:
Date | Finding |
---|---|
- ECHO/ date:
- Trans-thoracic:
- Trans-esophagus:
- CXR/ date:
- Other imaging and diagnostic tests/ date:
- Clinical course:
- Treatment:
- Outcome: