BACKGROUND 1234.pptx
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The trial used an "all-comers" design and excluded patients with previous interventions or acute myocardial infarction without consulting local doctors. Patients assigned to one treatment but receiving another or neither were analyzed based on their assigned treatment. The study also included registries of patients not eligible for randomization due to clinical characteristics, including those not suitable for CABG due to comorbidities or no graft material or for PCI due to complex anatomy or untreated chronic total occlusions. The primary endpoint was a composite of death, stroke, heart attack, or revascularization over 12 months as adjudicated by an independent committee.
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The document summarizes findings from the SYNTAX trial which compared percutaneous coronary intervention (PCI) with drug-eluting stents to coronary artery bypass grafting (CABG) in patients with complex coronary artery disease involving three vessels or the left main coronary artery. The trial found that rates of death, stroke, or heart attack were similar between PCI and CABG at 12 months. However, CABG was superior to PCI in reducing the risk of major adverse cardiac or cerebrovascular events. The rate of repeat revascularization was significantly higher in the PCI group. Among patients with the most complex disease, as indicated by high SYNTAX scores, the event rate at 12 months was significantly higher in the PCI group compared to CAB
Background 123.pptx
The SYNTAX trial compared percutaneous coronary intervention (PCI) using drug-eluting stents to coronary-artery bypass grafting (CABG) for treating patients with previously untreated three-vessel or left main coronary artery disease. It was a prospective, international clinical trial involving over 1,800 patients across 85 sites. The primary outcome was a composite of death, stroke, or myocardial infarction within 5 years. Patients were assessed using the SYNTAX score to evaluate disease complexity. The trial found CABG resulted in better long-term outcomes than PCI for patients with more complex multi-vessel coronary artery disease.
Presentation334545.pptx
A CT pulmonary angiogram was ordered due to elevated creatinine and potassium levels. The lung perfusion scan found multiple perfusion defects. A follow up normal lung perfusion scan showed resolution of the previously detected defects.
CARDIOLOGY SPOTTER 1111111.pptx
A 70-year-old man presented with right sided chest pain and dyspnea for 2 weeks. An ECG showed no significant ST or T wave changes. He was found to have significant right ventricular dysfunction and pulmonary oligemia.
answer.pptx
This document discusses acute pulmonary embolism, including its clinical features, diagnosis, and management. It presents pulmonary embolism as a blockage in the lungs caused by blood clots that can be life-threatening. Diagnosis involves tests like a CT scan or lung scan to detect clots, while treatment focuses on anticoagulant drugs to prevent further clotting as well as other procedures in severe cases. Managing the condition requires identifying risk factors, diagnosing properly, and providing appropriate treatment to resolve symptoms and reduce long-term complications.
qqq.pptx
Heart failure with preserved ejection fraction (HFpEF) is a condition where the heart muscle stiffens, making it difficult to fill and pump blood efficiently. While medications like candesartan and empagliflozin can help reduce hospitalizations for HFpEF by improving symptoms, other drugs like irbesartan and spironolactone have not shown benefits. Management of HFpEF focuses on controlling blood pressure, reducing fluid retention, and treating the underlying causes.
SYNTAX TRIAL.pptx
- The SYNTAX trial compared outcomes of percutaneous coronary intervention (PCI) using drug-eluting stents versus coronary artery bypass grafting (CABG) for treating three-vessel or left main coronary artery disease.
- For the primary endpoint of major adverse cardiac and cerebrovascular events at 12 months, CABG was superior to PCI. However, outcomes were similar between treatments for patients with less complex disease as measured by low or intermediate SYNTAX scores.
- For patients with more complex disease and high SYNTAX scores, CABG had significantly fewer primary events than PCI at 12 months.
JVP AND WAVEFORMS.ppt
This document provides an overview of jugular venous pressure and waveforms. It discusses the anatomy of the jugular veins and the technique for measuring jugular venous pressure at the bedside. Normal jugular venous waveform patterns are described including the a, x, c, x', v, and y waves. Abnormal waveform patterns are also outlined that may indicate conditions like tricuspid regurgitation, constrictive pericarditis, pulmonary hypertension, and cardiac tamponade. The document concludes with how jugular venous waveforms can help identify various cardiac arrhythmias.
SUDDEN CARDIAC DEATH.pptx
This document provides an overview of sudden cardiac death, including its definition, epidemiology, risk factors, etiologies, clinical features, management, and prevention. Some key points include:
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- Risk factors include increasing age, male sex, coronary heart disease, smoking, elevated cholesterol, emotional stress, depression, low socioeconomic status, and left ventricular dysfunction.
- Transient factors like ischemia, electrolyte abnormalities, drugs, and autonomic influences can trigger lethal arrhythmias in those with underlying structural heart issues. Antiarrhythmic drugs in particular carry
case presentation.pptx
A 13-year-old female presented with central chest pain radiating to the left shoulder associated with sweating and one episode of syncope. ECG showed non-specific ST-T wave changes and echocardiogram found mild left ventricular systolic dysfunction, moderate mitral regurgitation, severe tricuspid regurgitation, mild pericardial effusion, and elevated cardiac markers. This supports a diagnosis of probable myopericarditis.
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BACKGROUND 1234.pptx
- 1. 1. Inclusion criteria: The trial used an “all-comers” design. 2. Exclusion criteria • Previous intervention • Acute myocardial infarction • Concomitant surgery. Patients meeting either of the first two exclusion criteria were, according to the trial design, excluded without consultation of the local interventional cardiologist and cardiac surgeon. The need for concomitant surgery was discussed with the local interventional cardiologist and cardiac surgeon. Data for patients who were assigned to one treatment but underwent the other and for those who did not undergo either revascularization procedure were analyzed in an intention-to-treat manner.
- 2. Registries Objective • Patients were identified who were not candidates for randomization based on clinical or anatomical characteristics and formed the basis for the registry experience: • Who were not candidates for CABG (inoperable patients) • Who were not candidates for PCI (technically not feasible)
- 3. Reasons for Registry Allocation PCI Registry- CABG ineligible due to: • Co-morbidities (70.7%) • No graft material (9.1%) • Small or poor quality of distal vessel (1.5%) • Patient refused CABG (5.6%) • Other (13.1%) CABG Registry- PCI ineligible due to: • Complex anatomy (70.9%) • Untreatable CTO (22.0%) • Unable to take anti-platelet medications (0.9%) • Patient refused PCI (0.5%) Other (5.7%)
- 4. PRIMARY END POINT • The primary clinical end point was a composite of major adverse cardiac and cerebrovascular events (i.e., death from any cause, stroke, myocardial infarction, or repeat revascularization) throughout the 12-month period after randomization. • An independent clinical events committee (including cardiologists, cardiac surgeons, and a neurologist;) • Adjudicated all primary clinical end points, staged procedures, and cases in which the sternum was reopened.