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

5. 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

6. plumbing…arteries
angiogram

9. 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 CP
JS revised

16. chambers and valves
Ultrasound or sonar

17. ISCHEMIC HEART DISEASE
Dr Tom Mabin
Vergelegen Mediclinic
Somerset West

20. 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