{"id":7508,"date":"2008-11-24T01:35:24","date_gmt":"2008-11-24T01:35:24","guid":{"rendered":"http:\/\/cardiophile.info\/?p=140"},"modified":"2008-11-24T01:35:24","modified_gmt":"2008-11-24T01:35:24","slug":"early-invasive-treatment-of-unstable-angina-cath-pci","status":"publish","type":"post","link":"https:\/\/johnsonfrancis.org\/professional\/early-invasive-treatment-of-unstable-angina-cath-pci\/","title":{"rendered":"Early invasive treatment of unstable angina"},"content":{"rendered":"<p><iframe loading=\"lazy\" width=\"560\" height=\"315\" src=\"https:\/\/www.youtube.com\/embed\/0fR_ctxbZMU\" title=\"YouTube video player\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture\" allowfullscreen=\"\"><\/iframe><\/p>\n<h2><span style=\"color: #008000;\">Early invasive treatment of unstable angina<\/span><\/h2>\n<p><strong>Early invasive treatment of unstable angina is recommended in high risk patients with:<\/strong><\/p>\n<p>Recurrent angina at rest or low level activity despite maximum medical therapy, indicating an unstable plaque or critical coronary narrowing<br \/>\nElevated troponin suggesting ongoing myocardial damage<br \/>\nNew ST segment depression at presentation<br \/>\nRecurrent angina with heart failure<br \/>\nHigh risk findings on noninvasive stress testing (in relatively stable patients)<br \/>\nDepressed LV systolic function with ejection fraction less than 40%<br \/>\nHemodynamic instability<br \/>\nAngina at rest with hypotension<br \/>\nSustained ventricular tachycardia<br \/>\nHistory of percutaneous coronary intervention within the past 6 months<br \/>\nPrior coronary artery bypass grafting<\/p>\n<p><strong>Relative contraindications for cardiac catheterisation \/ percutaneous coronary intervention:<\/strong><\/p>\n<p>Uncontrolled hypertension, heart failure or arrhythmia &#8211; to be stabilised prior shifting to cath lab if feasible. Sometimes stabilization may not be possible without revascularization.<br \/>\nRecent cerebrovascular accident (within 3\/6 months)<br \/>\nInfection<br \/>\nElectrolyte abnormalities (K, Mg)<br \/>\nAcute gastrointestinal bleed or anemia of unknown etiology<br \/>\nAcute renal failure<br \/>\nCoagulopathy<br \/>\nPregnancy<br \/>\nMedication toxicity (digoxin)<br \/>\nUncooperative patient<\/p>\n<p><strong>Role of coronary artery bypass grafting in unstable angina:<\/strong><\/p>\n<p>Coronary artery bypass grafting in unstable angina is recommended if there is significant left main coronary artery disease, three vessel disease or two vessel disease with significant proximal LAD disease (left anterior descending coronary artery) and either ejection fraction less than 50% or ischemia on noninvasive testing. Many of these cases are now managed with percutaneous coronary intervention with availability of better hardware and operator expertise.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Early invasive treatment of unstable angina <\/p>\n","protected":false},"author":1,"featured_media":37978,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"nf_dc_page":"","footnotes":""},"categories":[18],"tags":[],"class_list":["post-7508","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-angiography-and-interventions"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.9 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Early invasive treatment of unstable angina - for high risk cases<\/title>\n<meta name=\"description\" content=\"Early invasive treatment of unstable angina is considered when there are clinical, ECG or laboratory evidence of high risk features.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/johnsonfrancis.org\/professional\/early-invasive-treatment-of-unstable-angina-cath-pci\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Early invasive treatment of unstable angina - 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