Angiographic features in the infarct-related artery after intracoronary urokinase followed by prolonged anticoagulation. Role of ruptured atheromatous plaque and adherent thrombus in acute myocardial infarction in vivo.

Background: In vivo imaging studies in patients with acute myocardial infarction (AMI) have demonstrated important lesions at sites other than the culprit. However, it is not well assessed whether non-culprit plaques in the non-infarct-related artery have similar markers of plaque instability compared to non-culprit plaques in the infarct-related artery. The aim of this study is to investigate the morphologic features of the non-culprit plaque in infarct-related artery in comparison with that in non-infarct-related artery for AMI patients using optical coherence tomography (OCT) in vivo. Methods: OCT examinations were attempted prospectively using motorized pullback in all 3 major coronary arteries (at least 2/3 segment of each artery) for 34 AMI patients. In 34 patients, 118 focal plaques were identified (3.5 plaques per patient). Qualitative OCT analyses for each focal atherosclerotic plaque were performed using the previously validated criteria. TCFA was defined as a plaque with lipid content in a quadrant and the thinnest part of a fibrous cap measuring <65 μm. A plaque rupture contained a cavity that communicated with the lumen with an overlying residual fibrous cap fragment. A thrombus was defined as an irregular mass protruding into the lumen. Non-culprit plaques were divided into two groups according to their location: plaques in infarct-related artery (n=35) and plaques in non-infarct-related artery (n=83). Results: Non-culprit TCFA, plaque rupture, and thrombus were observed in 50 lesions of 26 patients (76%), 14 lesions of 11 patients (34%), and 27 lesions of 15 patients (44%), respectively. OCT analyses are shown in the Table . Conclusions: The morphology of non-culprit plaques in AMI patients is similar whether these plaques occur in the infarct-related artery or the non-infarct-related artery. This suggests that plaque destabilization is a systemic phenomenon rather than a local, artery-specific process. OCT Analyses

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Role of electrocardiogram in identifying the infarct related artery in acute myocardial infarction and to correlate it with 2D echo and coronary angiogram

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20200657 ◽

2020 ◽

Vol 7 (3) ◽

pp. 451

Author(s):

Jacob Abraham Ruram ◽

Rami Reddy Ganta ◽

P. Arunachalam

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Artery Occlusion ◽

Inferior Wall ◽

St Segment Elevation ◽

St Segment ◽

Infarct Related Artery ◽

St Elevation ◽

Sensitivity Specificity

Background: The Electrocardiogram remains a crucial tool in the identification and management of acute myocardial infarction. A detailed analysis of patterns of ST segment elevation may influence decisions regarding the perfusion therapy. This study was undertaken to study the role of ECG in identifying the infarct related artery in acute ST elevation MI and to correlate its findings with 2 D ECHO and Coronary angiogram.Methods: A total of 100 patients who presented with acute ST elevation MI were randomly selected for the study. After admission all the patients underwent ECG, CPK, CK-MB levels, 2D ECHO and CAG. Patients with ST segment elevation from ECG was evaluated to identify culprit vessel and the ECG findings were then correlated with 2D ECHO and CAG to identify the Sensitivity, Specificity, Positive predictive value and Negative predictive value of ECG in identifying the infarct related artery.Results: Fifty-two (52%) patients had an Anterior wall MI, forty-two patients (42%) had an evidence of Inferior wall MI and Six patients (6%) were found to have Antero inferior wall MI in the study group. Thirty-eight (38%) had evidence of SVD, forty-six patients (46%) had DVD and Sixteen patients (16%) had TVD. Sensitivity, Specificity, PPV and NPV of the ECG in identifying the LAD artery occlusion were 60.5%, 100%, 100% and 44.4% respectively. Sensitivity, Specificity, PPV and NPV of ECG in identifying the RCA artery occlusion were 78.5%, 100%, 100% and 78.5% respectively. Sensitivity, Specificity, PPV and NPV of the ECG in identifying the LCx artery occlusion were 26%, 96%, 86% and 60% respectively.Conclusions: ECG was found to be a sensitive and specific tool in identifying the infarct related Coronary artery in acute ST elevation MI.

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TERAPIA TROMBOLÍTICA NO IAM: UMA REVISÃO DA LITERATURA

Revista Recien - Revista Científica de Enfermagem ◽

10.24276/rrecien2358-3088.2017.7.20.22-30 ◽

2017 ◽

Vol 7 (20) ◽

pp. 22

Author(s):

Carlos Alves dos Santos

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Literature Review ◽

Thrombolytic Therapy ◽

Nursing Care ◽

Atheromatous Plaque ◽

The Universe ◽

Infarto Del Miocardio ◽

De Medicina

O infarto agudo do miocárdio (IAM) é causado pela obstrução de uma ou de ambas as artérias coronárias por uma placa de ateroma. Quando isso ocorre em algumas circunstâncias é necessário instituir a terapia trombolítica, que consiste na administração de um fármaco que dissolve essa placa. O objetivo deste estudo foi investigar o papel do enfermeiro na terapia trombolítica diante do IAM. Tratou-se de um trabalho de revisão da literatura. Para isso, utilizou-se como fonte de pesquisa o site de busca da BIREME (Biblioteca Regional de Medicina). Do universo de 15 artigos, observou-se que 6 artigos mencionavam de forma indireta o papel do enfermeiro na terapia trombolítica e apenas 1 artigo citava os cuidados de enfermagem. Notou-se que o papel do enfermeiro vai além dos cuidados de enfermagem descritos nos livros de enfermagem.Descritores: Infarto do Miocárdio, Fibrinólise, Cuidados de Enfermagem. Thrombolytic therapy in AMI: an review of the literatureAbstract: Acute myocardial infarction (AMI) is caused by obstruction of one or both of the coronary arteries by an atheromatous plaque. When this occurs in some circumstances, it is necessary to institute thrombolytic therapy, which consists of the administration of a drug that dissolves this plaque. The objective of this study was to investigate the role of nurses in thrombolytic therapy in the presence of AMI. It was a work of literature review. To do this, the BIREME (Regional Library of Medicine) website was used as research source. From the universe of 15 articles, it was observed that 6 articles mentioned in an indirect way the role of the nurse in thrombolytic therapy and only 1 article cited nursing care. It was noted that the role of the nurse goes beyond the nursing care described in the in the nursing books.Descriptors: Myocardial Infarction, Fibrinolysis, Nursing Care. Terapia trombolítica en el IAM: una revisión de la literaturaResumen: Infarto agudo del miocardio (IAM) es causada por la obstrucción de una o ambas arterias coronarias por ateroma. Cuando esto ocurre por algunas circunstancias es una necesidad la terapia trombolítica, que comprende la administración de un fármaco que disuelve esta placa. El objetivo de este estudio fue investigar el papel de la enfermera en la terapia trombolítica antes del IAM. Se realizó un trabajo de revisión de la literatura. Para esto, se utilizo como una fuente de la investigación del site de busca de la BIREME (Biblioteca Regional de Medicina). Escogido el universo de 15 artículos, se observó que 6 artículos, menciona indirectamente el papel de las enfermeras en la terapia trombolítica siendo que sólo 1 artículo citaba los cuidados de enfermería. Se observó que el papel de la enfermera va más allá de la atención de enfermería que se describe en los libros de enfermería.Descriptores: Infarto del Miocardio, Fibrinólisis, Cuidados de Enfermería.

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