A 87-year-old woman with a CFS of 7 (severely frail) has been diagnosed with a new non-ST-elevation myocardial infarction. She has a background of adv...

Question

A 87-year-old woman with a CFS of 7 (severely frail) has been diagnosed with a new non-ST-elevation myocardial infarction. She has a background of advanced dementia, CKD stage 4, and recurrent falls. She is bedbound and dependent for all personal care. Her family is present. What is the MOST appropriate approach to management?

Accepted Answer

Focus on symptom management, discuss goals of care with family, and avoid invasive interventions given her frailty, comorbidity burden, and prognosis

Answer

Proceed with coronary angiography and percutaneous coronary intervention

Answer

Start full dose DAPT, Fondaparinux, and refer for urgent angiography

Answer

Administer thrombolysis as she is too frail for angiography

Answer

Discharge home with no treatment as she has advanced dementia

uk-dgm MCQ (SBA): Frailty-Informed Decision-Making in Acute Coronary Syndrome