Evidence-Based Coronary Care

Evidence-Based Coronary Care

By Mark Connaughton, BA, MB,BS, MRCP, MD, The University of Birmingham, Senior Registrar in Cardiology, Department of Cardiovascular Medicine, Queen Elizabeth Hospital, Birmingham, UK


1.1 Immediate management of chest pain compatible with MI
Immediate treatment.
Definitive treatment
Contra-indications to thrombolytic therapy
Management of the patient ineligible for thrombolytic therapy
Who should receive tPA?
Assessing reperfusion after thrombolysis
Problems following thrombolytic therapy
Patients with diabetes and acute MI
Treatment of 'difficult' MIs

SECTION II: SUBSEQUENT CCU MANAGEMENT OF MI
Early CCU management
Early risk stratification
Routine management from day 1
Complications of MI

SECTION III: RISK STRATIFICATION POST MI
Clinical risk stratification
Using exercise and other stress testing
Autonomic markers of post MI risk
Out-patient follow up
Pre-discharge checklist

SECTION IV: EARLY REHABILITATION, SECONDARY PREVENTION AND OUT-PATIENT FOLLOW-UP OF MI
Cardiac rehabilitation and secondary prevention
Fitness to drive
Checklist for outpatient review post MI

SECTION V: MANAGEMENT OF OTHER ACUTE CORONARY SYNDROMES
Unstable angina
Non-Q wave MI
Pre-discharge checklist

SECTION VI: DRUGS IN COMMON USE IN MI AND UNSTABLE ANGINA
Aspirin and other anti-platelet agents
Beta-blockers
Calcium antagonists
ACE inhibitors
Lipid lowering agents
Nitrates
Inotropes
Heparin, warfarin and antithrombins
Amiodarone

SECTION VII: OTHER EMERGENCIES IN CCU
Tachycardias
Bradycardias
Pacemakers
Automatic cardioverter-defibrillators