Case presentation Optimal management of STEMI Cardiology Update - PowerPoint PPT Presentation

Feb 20, 2024 •158 likes •368 views

Case presentation Optimal management of STEMI Cardiology Update 2013 Davos 14.2.2013 Daniel Srder, MD Fondazione Cardiocentro Ticino Crucial factors in management of STEMI (among others ) 1. Time o What counts: FMC to reperfusion 2.

Case presentation Optimal management of STEMI Cardiology Update 2013 Davos 14.2.2013 Daniel Sürder, MD Fondazione Cardiocentro Ticino
Crucial factors in management of STEMI (among others… ) 1. Time o What counts: FMC to reperfusion 2. Antiplatelet regimen o What counts: Early administration (FMC !) 3. Thrombus removal o Do it whenever possible and until proximal thrombus is removed 4. PCI/Stenting 5. Cardiac rehabilitation / secondary prevention
Case - 42 years old lady - absence of a significant medical history - typical anginbal chest pain since 30 min - alerts the ambulance
Ticino Roveredo (GR)
Direct transmission of the ECG to the invasive cardiologist on duty
Ticino Roveredo (GR) Regional Hospital Bellinzona A Stop takes between 30 and 60 min of time !!!
Arrival in the Cath-lab - asymptomatic - complete normalization of the ECG - hemodinamically stable What to do ?  Perform coronary angiogram ?  Wait and see (CCU) ?  CT scan ?  Other ?
How would you treat this (spontaneous) coronary dissection in a young women ?  Perform PCI ?  Wait and see (+/- GPIIb/IIIa inhibitors) ?  CABG ?  Other ?
Our option:  Wait and see (+ 36 h GPIIb/IIIa inhibitors) spontaneous healing ?
2 hours after interution of GPIIb/IIIa inhibitor:  Chest pain and ST elevation

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