Heart Disease Is The Leading Cause Of Death

Fibrinolytic therapy uses drugs to break up blood clots. This therapy is used with heart attack patients to remove the blockage that caused the myocardial infarction. Another treatment option is percutaneous coronary intervention (PCI). PCI involves the placement of a catheter into the blocked artery to allow blood to flow. The purpose of this paper is to examine the outcomes of these two procedures and to suggest that percutaneous coronary intervention is superior to fibrinolytic therapy.

Such contraindications could be an intolerance to long-term antiplatelet therapy or significant conditions leading to a reduced lifespan in the patient. If there is a lack of cardiac surgical support or the artery has suffered less than 50% or complete occlusion, the procedure may be voided. The patient also must not have received a bypass graft to the left anterior descending artery. (http://www.merckmanuals.com/professional/cardiovascular-disorders/cardiovascular-tests-and-procedures/percutaneous-coronary-interventions). Careful approach should be used in cases where patients suffer from diabetes and coronary artery disease or have left main disease without collateral flow and a high Syntax score. (http://emedicine.medscape.com/article/ 161446-overview).

Thus, in the current era, It is much more common to perform interventional cardiac catheterization rather than for

The advantages and disadvantages of staged complete revascularization (SCR) comparing to complete revascularization treated immediately (ICR) during primary PCI remain controversial also. While that may be the case, the optimal strategies to perform PCI in MVD patients still remain elusive and an area of robust research. In the past, the 2011 American College of Cardiology Foundation/American Heart Association/Society for Cardiac Angiography and Interventions (ACCF/AHA/SCAI) 7 and 2012 ESC guidelines 8 both advocated that index PCI should be limited to the infarcted vessel only unless there is hemodynamic compromise or refractory ischemia after the procedure, and complete revascularization (CR) is considered

Interventional Cardiology:non-surgical procedures used for treating cardiovascular diseases. They use catheters for diagnostic testing of the heart and it blood vessels.(3)

Peripheral arterial disease (PAD) affects 20% of adults over the age of 55 in the United States1. Research has found that this disease strongly correlates with the prevalence of myocardial infractions, strokes, and other vascular problems that result in death. With an increase in survival rates among Americans in general there will likely be more patients who are living with peripheral arterial disease. Primary care physicians currently under-diagnose PAD, which limits the options to manage this disease with secondary preventative measures2. In order to manage and prevent the effects of this disease it is important to understand the pathology, incidence, etiology, clinical manifestations, diagnosis, prognosis, and the treatment options for

The patient is usually awake during angioplasty, and chest discomfort may be experienced during the procedure. The patient remains awake in order to monitor the patient symptoms. If symptoms indicate the procedure is causing ischemia the cardiologist may alter or abort the part of the procedure. Bleeding from the insertion point in the groin (femoral artery) and wrist (radial artery) is common, in part due to the use of antiplatelet drugs. Some bruising is therefore to be expected. But occasionally a hematoma may form. This may delay hospital discharge as flow from the artery into the hematoma may continue which requires surgical repair. Infection at the skin puncture site is rare and dissection of the access blood vessel is

Cardiac catheterization is often referred to as coronary angiography or a coronary angiogram. It is a radiographic procedure that is used to look at and visualize the heart and the coronary arteries. During a cardiac catheterization it is possible for the cardiologist performing the procedure to see how effectively blood is flowing through the coronary arteries. In addition, this procedure allows the cardiologists to see how blood is moving through the chambers of the heart and how effective the heart valves are functioning. A cardiac catheterization can also allow for the visualization of the movement of the walls of the heart to see if the pumping action of the heart is normal.

arteries totally blocked181. Damage is reversible for approximately 20-30 minutes after complete obstruction of blood flow; thereafter myocardial cell death ensues and progresses as time passes182-184. Therefore, complete and sustained restoration of blood flow must be as prompt as possible to ensure maximum salvage of functional myocardium, a principle expressed in the maxim “time is muscle”185. This is achieved with reperfusion therapy, which is based on invasive reopening of the afflicted coronary artery with primary PCI, or non-invasive breaking up of the responsible blood clot with a thrombolytic drug186. Patients without ST-elevation are said to suffer from NSTEMI and tend not to have full occlusion of a coronary artery187. If there is evidence of myocardial cell death they are considered to have a NSTEMI; otherwise they are classified as suffering from unstable angina188. Their management is based on the estimation of their risk for adverse events. Patients at low risk can be adequately treated with medical therapy, in many ways similar to the one used for STEMI189-190. Those at moderate to high-risk benefit from an early invasive strategy, which includes coronary angiography, and if necessary, revascularization with

There are three different types of an acute coronary syndrome. There is unstable angina, a non-ST elevation myocardial infarction (NSTEMI), and there is a ST elevation myocardial infarction (STEMI). A STEMI and NSTEMI are both deciphered as a myocardial infarction, or better known as a heart attack. The difference between the two is that a STEMI is a fully blocked coronary artery, and a NSTEMI is a partially blocked one. “A heart attack occurs when the blood flow that brings oxygen to the heart muscle is reduced or cut off” (Heart Attack, 2017). The acute coronary syndrome, NSTEMI, will be discussed in this paper including these topics: description of the condition, medical/surgical treatment,

Coronary artery disease also known as CAD, is the narrowing of the arteries, that’s caused by expansion of plaque. When compared to other forms of modality for diagnosing coronary artery disease it may be the method of choice. When myocardial perfusion imaging is directly compared to exercise echocardiography, comparable sensitivities were revealed. When compared to myocardial contrast echocardiography or cardiac magnetic resonance imaging similar comparison was seen. Myocardial perfusion imaging may be used if a different test was vague just as if myocardial perfusion imaging was inconclusive a different modality may be used. For women ECG (electrocardiogram) is usually the diagnostic of choice. There have been several studies that have concluded that ECG maintain a high number of false positive in women. With using MPI it’s more sensitive in diagnosing coronary artery disease in women. According to Loong (2004) “A recent study was performed where out of 1140 women 86% of women were diagnosed with coronary artery disease by MPI” (p.4). Some physicians suggest that women who have an intermediate probability of coronary artery disease, myocardial perfusion imaging is the non-invasive

The stent data for more complex lesions such asTASC C/D and other CTO lesions are also encouraging. According to two recent T2meta-analyses immediate technical success ratesfor aorto-iliac intervention exceed 90%, with 4–5 years primary patency rates of 60–86%, secondary patencyrates of 80–98%, and limb salvage rates of 98%. TheSTAG trial compared primary stenting with percutaneoustransluminal angioplasty for iliac occlusion andshowed stents improved technical success, but no statistical differencewas noted between groups at 1 or 2 years in primaryor secondary patency.(Goode et al,

Conclusion: Percutaneous coronary intervention and TAVR execution as a single procedure can occur in discerning patient population as it does not increase the risk of mortality even in the setting of severe multi-organ involvement.

Individuals admitted with symptoms of cardiogenic shock, inability to consent for procedure, history of aortobifemoral bypass, lack of bilateral radial or femoral arterial pulse, involvement in another ongoing research study, treatment with oral anticoagulants, and negative Allen’s test were considered ineligible. The study was conducted between October 2009 and February 2012, in which researchers measured net adverse clinical events (NACE) (stroke, major bleeding/vascular complications, death, and myocardial infarction (MI)) and secondary endpoints (major adverse cardiovascular events, technical achievement, access site failure, procedural and fluoroscopy times, amount of contrast, critical care length of stay, and all-cause mortality at six months). A total of 707 patients with evidence of ST-elevations seen on 12-lead EKG were randomly dispersed to either the radial access group (n= 348) or the femoral access group (n= 359) for PCI in four different qualified facilities. All study participants had a follow-up at one month and at 6 months. According to the findings, at one month, the NACE rate was significantly lower in the radial group (4.6%) compared with the femoral group (11%) with a p value

This patient is a 74-year-old male who required inpatient hospitalization due to: He experienced an episode of supraventricular tachycardia while riding his bicycle, had a syncopal episode, and was taken to an Emergency Department. Supraventricular tachycardia was terminated; thereafter he was diagnosed to have paroxysmal afibrillation. After an abnormal stress test, left heart catheterization revealed severe multivessel coronary artery disease, including a chronically totally occluded right coronary artery. He was referred for surgical revascularization. Based upon these data, patient was scheduled for bypass surgery. His medical history was significant for coronary artery disease, history of paroxysmal afibrillation, hypertension, hyperlipidemia,