Discover and read the best of Twitter Threads about #pci

Most recents (3)

1. “STEMI equivalent” #ECG patterns is crucial for every👨🏻‍⚕️👩🏻‍⚕️ dealing with #ACS.
-in 10-25% pts for urgent #PCI
📍Wellens’ syndrome
📍de Winter sign
📍hyperacute T waves,
📍left bundle branch block (LBBB)
📍right bundle branch block (RBBB)

2.📍Wellen’s syndrome📍
(other names Wellens' sign, Wellens' warning, Wellens' waves):
is a pattern of deeply inverted or biphasic T waves in V2-3, which is highly specific for a critical stenosis of the left anterior descending artery (LAD)
3.📍de Winter sign📍
-ECG abnormality described by de Winter et al. in 1998
-Characterized by 1-3 mm of ST-depression with upright, symmetrical T-waves
-Suspicious for proximal occlusion of the LAD
-Recognized as a STEMI equivalent by Rokos et al. in 2010
Read 6 tweets
#WeeklyCardioReview Left main: #PCI or #CABG? A methodological review of #EXCELtrial and #NOBLEtrial, research in context and final answer to what should I do with my patient with #LMdisease. Stay tuned, enjoy and comment
#EXCELtrial Intended population: 2010-2014
1. LM >70% visually, or >50% hemodynamically significant
2. Heart team suitable for both Tx
3. SYNTAX score <32
Actual population:
Core lab detected high SYNTAX score (≥33) in 24.2%
Distal LM 80.5%
2 or 3 VD 51.3%
Most common exclusion criteria: Disease too complex for PCI (31.9%)
1905 pts randomized, small cross overs, balanced LTFU
Read 32 tweets
1/10 #STEMI from ruptured plaque, less plaque erosion. @BraunwaldEugene pic demonstrates LDL oxidized, glycated➡️cytokines release express adhesion molecules➡️monocytes roll, diapedesis➡️ingest LDL, become foam cell➡️SMC migrate, proliferate➡️some apoptosis➡️plaque
2/10 Why #STEMI on #ECG
1. Diastolic current of injury: current away from relatively depolarized injury➡️TQ depression➡️normalized on ECG➡️ST elevation
2. Systolic current of injury: current towards injury due to early repol➡️ST elevation
Read 19 tweets

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