STEMI part 2- Questions and case scenarios- Elias Hanna

[@haithambatarseh866]

What a brilliant lecture

[@ahmeddaoud9901]

What a great Lecture , deeply Thanks

[@leo93jesi]

Such a good lesson! Greetings from Italy, you’re a pleasure to hear!

[@areenal-taie6836]

Impressive !
Thank you very much Dr Hanna

[@namphan6911]

Thank you for such a fantastic lecture Professor. In my experience, the issue of STEMI late-comers still has quite a bit of nuances. Let me present a specific scenario to illustrate my point: Anterior STEMI (QS + STe 1mm in V1 -> V4), chest pain suggestive of angina 5 days ago, hs Troponin T 2603 -> 2720 ng/L. Bedside echo: LVEF 35%, ischemic heart disease, LV not dilated. The patient eventually underwent elective invasive angiography the next day (Class IIB per your lecture) which revealed total occlusion of ostial LAD, non-significant stenosis of LCx and RCA.
1/ If the patient still complains of pain and distress, will you PCI the occluded LAD?
2/ If the patient no longer has chest pain, I understand that PCI is not indicated in this patient (OAT trial). However, given the LVEF of 35% (most likely left ventricular dysfunction/heart failure post MI), how would you manage this patient after the angiogram? Will you do stress test to further evaluate ischemia (and thus, indication for PCI of the occluded LAD), and if yes, how (which modality) and when (timing post STEMI)?
3/ If the patient no longer has chest pain, but the main symptom now is dyspnea suggestive of congestion due to heart failure post-MI (say Killip II, elevated NT-proBNP), will there be indication for LAD PCI?

[@Aboou2024]

Thanks so much dear prof. Great lecture as usual

[@ashwindaware4720]

Thanks sir for wonderful lectures and practical tips.

[@umerqadeer191]

Great lecture like always. Dear Dr Hanna can you please give a lecture/lectures on how to perform Primary PCI ?

[@aroojzahid3138]

Simply no match just like always.

[@Nikesnipe]

Thanks a 100 Times, Greetings From Germany

[@monamatni7229]

Thank you very much ع راسي ولله شكرا جزيلا

[@remonsobhi6231]

we need a lecture about acute pulmonary embolism

[@thippeswamygs7436]

Brilliant lecture.. Very practical.... Hats off to you sir
Sir please give lecture on pacemakers both temporary and permanent.. Thank you🙏🙏

[@mahmoud27898]

Thanks

[@zubairwarraich242]

Thank you so much

[@abdellateefm]

Thanks need this slide

[@Mohamed-cz7kc]

thank you sir❤