Dr. Usman's Cardiology Notes

MASTER COMPENDIUM — MAJOR CARDIOLOGY TRIALS (Ischemia, ACS, PCI, CABG, Lipids, HTN, Valves, HF-adjacent, VTE, PAD, Diabetes CVOTs, Stroke,Cardiac Electrophysiology, CRT, ICD, Atrial Fibrillation, VT etc.) --- DOWNLOAD PDF OF ALL CARDIOLOGY TRIALS HERE CLICK HERE 👉 DOWNLOAD   👇 Or You can Read All Here 👇  1. ACUTE CORONARY SYNDROME / MYOCARDIAL INFARCTION / FIBRINOLYSIS ISIS-2 Conclusion: Aspirin + streptokinase after acute MI markedly reduced mortality vs neither therapy. Key Points: Established aspirin as essential; demonstrated benefit of early reperfusion with fibrinolysis. GISSI-1 / GISSI-2 Conclusion: Early fibrinolysis reduced mortality; later GISSI refined therapies and showed benefits of ACE inhibitors and other measures. Key Points: Important early large trials shaping acute MI care pathways. GUSTO-I Conclusion: Accelerated tPA strategy reduced 30-day mortality versus streptokinase in STEMI. Key Points: Emphasized speed of reperfusion; informed primary PCI era tran...

 

A 38 year old male smoker and hypertensive presented with severe retrosternal chest pain of 3 hours duration. On examination he was hypertensive with BP = 80/50 sinus bradycardia with HR 40bpm, right sided S3 and chest clear. He recently underwent primary PCI to LAD a month ago, coronary angiogram at that time revealed LAD 90% stenosis, LCX mid 50% stenosis, RCA proximal 60-70% stenosis and Right PDA has 80% osteal stenosis.   ECG on current presentation showed sinus bradycardia and ST depressions more than 2mm in inferior leads. Please give answer of following questions based on guidelines a)       Is TPM indicated, if yes then give justification b)       Name the culprit vessel c)       Do you think revascularization of non-culprit vessel at time of primary PCI would have prevented current cardiac event d)       Name the trials which have studied such scenarios Answers: a. ...