By Ever D. Grech
Wide, and occasionally complicated, elements of interventional cardiology are provided in a transparent, concise and balanced demeanour. this straightforward to learn textual content, supplemented via quite a few pictures and snap shots, will attract a huge readership, together with clinical scholars, relatives medical professionals, physicians, and cardiology.
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Extra resources for ABC of Interventional Cardiology
There are logistical hurdles in delivering a full 24 hour service. Primary angioplasty can be performed only when adequate facilities and experienced staff are available. The time from admission to recanalisation should be less than 60 minutes, which may not be possible if staff are on call from home. However, recent evidence suggests that, even with longer delays, primary angioplasty may still be superior to thrombolysis. A catheterisation laboratory requires large initial capital expenditure and has substantial running costs.
Ventricular arrhythmias are not unusual on recanalisation, but these generally occur while the patient is still in the catheterisation laboratory and can be promptly treated by intravenous drugs or electrical cardioversion. Right coronary artery procedures are often associated with sinus arrest, atrioventricular block, idioventricular rhythm, and severe hypotension. Up to 5% of patients initially referred for primary angioplasty require urgent coronary artery bypass surgery, so surgical backup is essential if risks are to be minimised.
In this case right ventricular myocardial infarction produces a unique set of physical findings, haemodynamic characteristics, and ST segment elevation in lead V4R. When this occurs aggressive treatment is indicated as the mortality exceeds 30%. Ventricular septal defect, mitral regurgitation, or myocardial rupture In 10% of patients with cardiogenic shock, hypotension arises from a ventricular septal defect induced by myocardial infarction or severe mitral regurgitation after papillary muscle rupture.
ABC of Interventional Cardiology by Ever D. Grech