Heart attack:the journey

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Presentation transcript:

Heart attack:the journey Dr Tom Mabin Vergelegen Mediclinic Somerset West

Plaque rupture STEMI NON-STEMI Without occlusion With occlusion ACS describes the clinical manifestations of disruption of cornary arterial plaque complicated by intraluminal thrombosis and distal embolisation. Distal embolisation results in a small troponin rise, which can predict serious proximal “hot” plaque/stenosis. Without occlusion With occlusion STEMI NON-STEMI

plumbing…arteries angiogram

Therapeutic Strategies in Community Hospitals Drip Thrombolytic drugs Drip and ship PCI Thrombolytics + transfer Ship – no drip Transfer (no thrombolytics) Fac. PCI Pharmaco-invasive strategy CP1257012-5 JS revised 2-16-2006

chambers and valves Ultrasound or sonar

ISCHEMIC HEART DISEASE Dr Tom Mabin Vergelegen Mediclinic Somerset West

B-Blockers;BP ;diabetes;gout Post stent Dispirin etc Clopidogrel Statin Recovery days Recurrence 20% pa Post CABG Disoirin etc Clopidogrel( month) Statin Recovery weeks Recurrence <5% pa B-Blockers;BP ;diabetes;gout