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The clinician must therefore be well versed in recognizing the so-called ECG mimics of acute myocardial infarction, which include left ventricular hypertrophy, left bundle branch block, paced rhythm, early repolarization, pericarditis, hyperkalemia, and ventricular aneurysm. [7] [8] [9] Localisation of the occlusion in the ECG showing STEMI changes
PPS can also be caused after a trauma, a puncture of the cardiac or pleural structures (such as a bullet or stab wound), after percutaneous coronary intervention (such as stent placement after a myocardial infarction or heart attack), or due to pacemaker or pacemaker wire placement. [1]
[2] [6] As the needle is advanced, aspiration is performed to assess for advancement of the needle into the pericardial space. [6] To prevent perforation of the heart, electrocardiographic (ECG) monitoring might be used. This involves using an alligator clip to attach an ECG lead to the needle.
Electrocardiography is the process of producing an electrocardiogram (ECG or EKG [a]), a recording of the heart's electrical activity through repeated cardiac cycles. [4] It is an electrogram of the heart which is a graph of voltage versus time of the electrical activity of the heart [ 5 ] using electrodes placed on the skin.
A 6-month follow up post-implantation of the radioactive stents showed little adverse side-effects in the patients. [6] However, more recent studies have shown that patients have a late progression of in-stent neointimal hyperplasia after 1 year of radioactive stent implantation, suggesting a delay in the development of neointimal hyperplasia ...
After placement of a stent or scaffold, the patient needs to take two antiplatelet medications (aspirin and one of a few other options) for several months to help prevent blood clots. The length of time a patient needs to be on dual antiplatelet therapy is individualized based risks of ischemic events and bleeding risk.
The ECG should be done as early as practicable, including in the ambulance if possible. [18] ECG changes indicating acute heart damage include: ST elevation, new left bundle branch block and ST depression amongst others. The absence of ECG changes does not immediately distinguish between unstable angina and NSTEMI. [6]
Stents, which are specially manufactured expandable stainless steel mesh tubes, mounted on a balloon catheter, are the most commonly used device beyond the balloon catheter. When the stent/balloon device is positioned within the stenosis, the balloon is inflated which, in turn, expands the stent and the artery.