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- Q4816772 subject Q7163797.
- Q4816772 abstract "Reperfusion therapy is medical treatment that restores blood flow through blocked arteries, typically after a heart attack (myocardial infarction). Categories of reperfusion therapy thus include clot-busting (fibrinolytic) drugs and procedures to open arteries with stents, or to graft arteries around blockages. These interventions have become so central to the modern treatment of acute myocardial infarction, that we are said to be in the reperfusion era. Patients who present with suspected acute myocardial infarction and ST segment elevation (STEMI) or new bundle branch block on the 12 lead ECG are presumed to have an occlusive thrombosis in an epicardial coronary artery. They are therefore candidates for immediate reperfusion, either with thrombolytic therapy, percutaneous coronary intervention (PCI) or when these therapies are unsuccessful, bypass surgery.Individuals without a ST segment elevation are presumed to be experiencing either unstable angina (UA) or non-ST segment elevation myocardial infarction (NSTEMI). They receive many of the same initial therapies and are often stabilized with antiplatelet drugs and anticoagulants. If their condition remains (hemodynamically) stable, they can be offered either late coronary angiography with subsequent restoration of blood flow (revascularization), or non-invasive stress testing to determine if there is significant ischemia that would benefit from revascularization. If hemodynamic instability develops in individuals with NSTEMIs, they may undergo urgent coronary angiography and subsequent revascularization. The use of thrombolytic agents is contraindicated in this patient subset, however.The basis for this distinction in treatment regimens is that ST segment elevations on an ECG are typically due to complete occlusion of a coronary artery. On the other hand, in NSTEMIs there is typically a sudden narrowing of a coronary artery with preserved (but diminished) flow to the distal myocardium. Anticoagulation and antiplatelet agents are given to prevent the narrowed artery from occluding.At least 10% of patients with STEMI don't develop myocardial necrosis (as evidenced by a rise in cardiac markers) and subsequent Q waves on EKG after reperfusion therapy. Such a successful restoration of flow to the infarct-related artery during an acute myocardial infarction is known as "aborting" the myocardial infarction. If treated within the hour, about 25% of STEMIs can be aborted.".
- Q4816772 thumbnail Intracoronary_thrombus.png?width=300.
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- Q4816772 comment "Reperfusion therapy is medical treatment that restores blood flow through blocked arteries, typically after a heart attack (myocardial infarction). Categories of reperfusion therapy thus include clot-busting (fibrinolytic) drugs and procedures to open arteries with stents, or to graft arteries around blockages. These interventions have become so central to the modern treatment of acute myocardial infarction, that we are said to be in the reperfusion era.".
- Q4816772 label "Reperfusion therapy".
- Q4816772 depiction Intracoronary_thrombus.png.