A 60-year diabetic & hypertensive male with second-grade prostatism admitted for prostatectomy developed myocardial infarction. Treatment now would be –
**Core Concept**
The management of a patient with acute myocardial infarction (AMI) in the perioperative period requires careful consideration of the patient's underlying conditions, including diabetes and hypertension. In this scenario, the patient is undergoing a non-emergent surgical procedure, prostatectomy, but has developed AMI, necessitating immediate attention to prevent further cardiac complications.
**Why the Correct Answer is Right**
The patient is at high risk for complications due to his underlying comorbidities, including diabetes and hypertension. In the setting of AMI, the primary goal is to restore blood flow to the affected myocardium, reduce ischemic damage, and prevent further cardiac complications. Given the patient's non-emergent surgical status, the treatment of choice would be to immediately prioritize cardiac stabilization and reperfusion therapy, rather than delaying surgery.
* **Option A:** Delaying prostatectomy is incorrect because it may not be feasible to delay surgery indefinitely, and the patient's underlying conditions require management in the perioperative period.
* **Option B:** Administering vasopressors without addressing the underlying AMI would be incorrect because it may worsen cardiac function and increase the risk of further complications.
* **Option C:** **Correct Answer:** **Administering thrombolytic therapy** is the correct choice because it can rapidly restore blood flow to the affected myocardium, reduce ischemic damage, and prevent further cardiac complications.
* **Option D:** Proceeding with prostatectomy without addressing the AMI would be incorrect because it may lead to catastrophic cardiac complications and increase the risk of perioperative mortality.
**Clinical Pearl / High-Yield Fact**
In the perioperative period, patients with a history of diabetes and hypertension are at increased risk for cardiac complications, including AMI. Prompt recognition and management of AMI are critical to preventing further cardiac damage and improving patient outcomes.
**Correct Answer:** C. Administering thrombolytic therapy