17 -reatment algorithm for the management of acute coronary syndrome with(!) ST-segment elevation

Question 1

what is the management with stemi

Answer 1

highest mortality rate during the first 30 min due to primary ventricular fibrillation

eadiness for electrical synchronization with the defibrillator and to continue with CPR

During the first 3 hours thrombolysis :

warfarin
acenocomural
clopidogrel

by medicaments is an alternative to PCI
but the risk of cranial hemorrhages is much lower with PCI. Thus, if there is a catheter lab, always make use of it and do PCI.
always try to do PCI as soon as possible

what are the thrombolysis given ?

Question 2

what is the risk for this intravenous procedure ?

Answer 2

Vascular complications – dissections, hematomas, false aneurisms.

2. Major hemorrhages: especially in patients with Percutaneous Coronary Intervention-> because of the high doses of anticoagulants in combination with ASA and Clopidogrel,
   3) Risk of transferring infections communicable hematologically -HIV , hva , hvb
   4) Risk of developing of contrast nephropathy – especially in patients with CKD
   5) Risk of allergic reactions towards the contrast agents or towards the procedural anesthesia or anticoagulants

Acute thrombosis -> Stent may damage endothelium, etc -> thrombosis