Thrombolysis

Diagnosis of ST Elevation MI and chest pain support. Charlie Bloe Clinical Ward Manager, CCU.

Acute CHD Presentations ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Acute Coronary Syndromes ST elevation MI Unstable Angina Non ST elevation MI

Atherosclerotic Plaque in Coronary Artery Lipid core Fibrous cap > Artery lumen Plaque rupture and thrombus formation

[object Object],[object Object],[object Object],[object Object]

The 12-lead ECG ,[object Object],[object Object],[object Object],[object Object]

The Six Limb Leads aVR aVL aVF N

The Six Limb Leads aVR aVL aVF Lead I Lead II Lead III N

Use the thoracic skeleton for landmarks The Chest Leads

Correct chest lead placement V1-V6 or C1-C6 V1 V2 V3 V4 V5 V6

6 + 4 = 12! ,[object Object],[object Object],[object Object],[object Object],[object Object]

[object Object],[object Object],Anterior - septal MI: V1 – V4 Lateral MI: Lead I, aVL, V5, V6

Diagnosis of Acute Coronary Syndromes ,[object Object],[object Object],[object Object]

Normal ECG complex ,[object Object],[object Object],[object Object]

ECG evolution in acute STEMI ,[object Object],[object Object],[object Object],[object Object],[object Object]

[object Object],[object Object],[object Object],[object Object],[object Object],ECG evolution in acute STEMI

Case Study (March 2010) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Raigmore ‘clot busters’ support team ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Impact on pre hospital thrombolysis (% of STEMI patients receiving PHT) Lots of myocardium saved!

Case study – Sept. 2010 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Case study ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Optimal Reperfusion Therapy. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

QIS standard for RACP (less acute chest pain) ,[object Object],[object Object],[object Object],[object Object],[object Object]

RACP clinic to date. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Thrombolysis

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Thrombolysis