Full Description
This book is open access under a CC BY 4.0 license.
This quick-reference handbook offers a concise and practical review of key aspects of the treatment of ST-segment elevation myocardial infarction (STEMI) in the era of primary percutaneous coronary intervention (PPCI). In the context of STEMI, PPCI is the preferred mode of emergency revascularization. Access to PPCI is rapidly increasing and is now routinely practiced in both general and specialist hospitals and there has been a recent emphasis on developing STEMI networks to enhance and expedite the referral pathway. This coupled with concurrent developments to enhance the safety and efficacy of the PPCI procedure has heralded an era where STEMI interventions are increasingly considered an important subspecialty within interventional cardiology.
Written by leading cardiologists who have been instrumental in the adoption of PPCI in their respective institutions, the book provides junior and senior cardiologists alike with insightful and thought-provoking tips and tricks to enhance the success of PPCI procedures, which may in turn translate into direct improvements in outcomes. The book is also relevant for healthcare providers and emergency department physicians.
Contents
Foreword.- Historical perspectives on management of acute myocardial infarction.- Pre-hospital diagnosis and management of acute myocardial infarction.- STEMI network and logistics - rural vs. urban.- Cath lab design, staffing, training.- Patient preparation and vascular access for primary PCI.- Management of intra-coronary thrombus.- Culprit only artery versus multi-vessel disease.- Pharmacologic therapies in primary PCI - antiplatelet agents.- Pharmacologic therapies in primary PCI - glycoproteins, heparins, bivalirudins, etc.- Pharmacologic therapies in primary PCI - inotropes, etc.- Drug-eluting stents vs. bare-metal stents in Primary PCI - Is there still a debate?.- Drug-eluting balloons in primary PCI.- High bleeding risk scenarios in primary PCI.- Mechanical complications of myocardial infarction - free-wall rupture, VSD, acute MR.- The role of mechanical circulatory support in primary PCI - IABP, ECMO, IMPELLA, LUCAS?.- Methods of reducing infarct size and reperfusion injury in primary PCI.- Time to reperfusion, door to balloon times, and how to reduce them.- Utilization of facilitated and rescue angioplasty in primary PCI.- Primary angioplasty: the economics.- Role of bypass surgery in acute myocardial infarction: indications, timing, outcome.- Role of intravascular imaging in emergency PCI.- Patients ineligible for primary PCI .
