STEMI Care, when Time is Muscle.

[@hchen77]

Great lecture. I have a question arising from the end about anticoagulation prep & CABG. How do we know if an acute patient has multivessel disease before sending him/her to the cathlab?

[@whiteboardandmarkercardiol2787]

We usually dont. Its only after the cath that we know for sure. Some of the risk factors like advanced age, Diabetes, low EF, AVR elevation on EKG or having PVD disease can guide you that the patient might have multivessel disease.
Thanks for watching

[@goldenpheasant]

Thanks for simplifying the whole topic. Small question: After giving ASA and Clopidogrel or Tricagrelor, how can one decide about Heparin ? What do you recommend?

[@whiteboardandmarkercardiol2787]

Vam Pire thanks. After ASA and plavix usually a bolus of 4000 units of heparin is given. If the patient has very low BMI you can give 3000 or 5000 units if the BMI is very high. In the cath lab while doing PCI we check ACT ( activating clotting time) to see how much extra heparin is needed. For PCI it is usually recommended to keep ACT around 300 and 250 if the patient is on IV integrellin.I hope this help

[@bn9891]

What is the difference between 2 contiguous vs 3 consecutive leads??

[@whiteboardandmarkercardiol2787]

Thanks for watching.
For lateral infarction two leads 1 and avl show lateral ifarction.
For inferior infarction three lead 2,3 and avf show inferior infarction.
These two and three leads are called contiguous leads.
Hope this help..

[@bn9891]

@@whiteboardandmarkercardiol2787 thank you for the quick reply!!