38 year old with recent ACS NSTEMI, DM, good LV function. If patient is not willing for CABG despite repeatedly explaining that would be better for him, how will you approach this?⁦Shariq Shamim⁩ ⁦Osama Bisht⁩

I am proud of my IC friends here.Who told we are doing unnecessary things😁?!!The hardest choices in life aren't between what's right and what's wrong but between what's right and what's best. Here the right thing and the best thing is CABG for him.I will go on talking.

@ShariqShamimMD @Obisht This is a classic case of where I would use the @djc795 line that although no one wants to have CABG, there are some people who need CABG. Just because someone doesn’t want CABG doesn’t mean we should offer PCI. Anatomy is terrible for PCI in a 35 year old.

@ShariqShamimMD @Obisht Frankly, I wouldn’t offer PCI as an option in this scenario. Just bc someone demands something doesn’t obligate us to provide it.

@ShariqShamimMD @Obisht Medical therapy until she understands the need for CABG.

@ShariqShamimMD @Obisht True

@ShariqShamimMD @Obisht This is when we tell him his only option is CABG. If he doesn't want a procedure then he can choose medical therapy. I would not even offer PCI.

@ShariqShamimMD @Obisht In the last 20 yrs that i have been doing this i have come across few young patientswith this much disease and i have been able to convince them all to go for cabg. Simply said Dont give him the pci option. We all know that for this patient CABG is far superior

@ShariqShamimMD @Obisht Yes. I am satisfied. All ICs unanimously told CABG. He will be convinced, started agreeing somewhat

@Obisht Saddening to see this in such young age…nothing will last long unless metabolic mess is corrected…DCB all?

@ShariqShamimMD @Obisht Will go medical .. PCI is not an option with this terrifying anatomy... might do more damage