Cardiology IV

HESA-110-01

ACS

Acute coronary syndromes result from a sudden blockage in a coronary artery. This blockage causes unstable angina or heart attack (myocardial infarction) depending on the location and amount of blockage.

Troponin

A blood test used to diagnose heart muscle damage. Used to diagnose NSTEMI.

STEMI

ST‑elevation myocardial infarction. Diagnosed using an EKG. These heart attacks must go immediately to the cardiac cath lab or receive thrombolytics.

NSTEMI

Non‑ST‑elevation myocardial infarction. Not readily apparent on the EKG and requires blood tests to diagnose. Some patients go to the cath lab immediately, but not all. They are never treated with thrombolytics.

Artificial Heart Valves

Damaged or malfunctioning valves can cause stenosis or regurgitation. Treatment options include mechanical valve replacement, bioprosthetic valve replacement (pig or cow), or valve repair. Mechanical valves require lifelong blood thinners.

Pacemaker

A device that uses electrical impulses to regulate heart rate by stimulating the heart muscle when the natural pacemaker is inadequate.

ICD

Implantable Cardioverter Defibrillator. A device placed in the chest or abdomen that delivers electrical pulses or shocks to treat life‑threatening arrhythmias, especially those causing sudden cardiac arrest.

LVAD

Left Ventricular Assist Device. A mechanical pump that supports heart function by taking blood from the left ventricle and pumping it into the aorta.

Thrombolytic

Clot‑dissolving drugs given to a person having a STEMI when PCI is not available within 90 minutes.

Coronary Angiogram

Imaging of the coronary arteries performed during left‑heart catheterization. A catheter is threaded into the coronary arteries and dye is injected to visualize blockages on fluoroscopy.

Left Heart Cath

A catheterization of the left (arterial) side of the heart, including the coronary arteries.

Right Heart Cath

A catheterization of the right (venous) side of the heart.

Myocardial Infarction

A heart attack caused by sudden and severe reduction of blood supply to part of the heart, leading to death of heart muscle.

Difference Between Myocardial Ischemia and Myocardial Infarction

Myocardial ischemia is reduced blood flow without death of heart muscle; myocardial infarction involves actual death of heart muscle.

Types of ACS

Unstable angina, NSTEMI, and STEMI.

How to Treat a STEMI

Treated with PCI or thrombolytics.

Advantages and Disadvantages of Thrombolytics for STEMI

Advantages: readily available and can be given through a peripheral IV by any physician. Disadvantages: risk of fatal bleeding; used only when a cath lab cannot be reached within 90 minutes.

Advantages and Disadvantages of PCI for STEMI

Advantages: lower bleeding risk and directly fixes the blockage. Disadvantages: requires a cardiologist and a cath lab.