Percutaneous coronary intervention (pci) after successful reestablishment of spontaneous circulation and during cardiopulmonary resuscitation

Marko Noc, Bjorn Bendz, Karl B Kern

Research output: Chapter in Book/Report/Conference proceedingChapter

2 Citations (Scopus)

Abstract

Introduction: Coronary artery disease represents the most important cause of out-of-hospital cardiac arrest. Immediate coronary angiography in patients after reestablishment of spontaneous circulation demonstrated angiographic evidence of coronary artery disease in 80% of patients, with the majority (90%) having significant obstructive stenoses of one or more coronary arteries. Experimental animal models have shown that coronary obstructions have a profound effect on the utility of cardiopulmonary resuscitation to perfuse the myocardium during cardiac arrest. We found that coronary diameter stenoses as little as 33% decreased distal perfusion by more than half (see Chapter 18 for more details). Postmortem examinations of sudden cardiac death victims indicate that unstable plaque with associated coronary thrombosis may be documented in more than 80% of the cases. Accordingly, acute coronary thrombotic events leading to critical narrowing or complete coronary obstruction and possibly distal microembolization may be a main trigger of sudden arrhythmic cardiac arrest. Current strategy for management of acute coronary syndromes: Acute coronary syndrome (ACS), based on 12-lead electrocardiogram, is traditionally divided into evolving ST segment elevation acute myocardial infarction (STEMI) and unstable angina/non-ST elevation myocardial infarction (UA/NSTEMI) (Fig. 42.1). More than 90% of the patients with STEMI have a complete thrombotic occlusion of the epicardial part of one of the coronary arteries without adequate collateral flow to the distal part of the affected artery. The mechanisms of coronary obstruction in patients with UA/NSTEMI are more heterogeneous.

Original languageEnglish (US)
Title of host publicationCardiac Arrest: The Science and Practice of Resuscitation Medicine
PublisherCambridge University Press
Pages764-771
Number of pages8
ISBN (Print)9780511544828, 05218470041, 9780521847001
DOIs
StatePublished - Jan 1 2007

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Cardiopulmonary Resuscitation
Percutaneous Coronary Intervention
Sudden Cardiac Death
Unstable Angina
Acute Coronary Syndrome
Coronary Artery Disease
Coronary Vessels
Out-of-Hospital Cardiac Arrest
Coronary Thrombosis
Coronary Stenosis
Heart Arrest
Coronary Angiography
Autopsy
Myocardium
Electrocardiography
Pathologic Constriction
Animal Models
Arteries
Perfusion
Myocardial Infarction

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Noc, M., Bendz, B., & Kern, K. B. (2007). Percutaneous coronary intervention (pci) after successful reestablishment of spontaneous circulation and during cardiopulmonary resuscitation. In Cardiac Arrest: The Science and Practice of Resuscitation Medicine (pp. 764-771). Cambridge University Press. https://doi.org/10.1017/CBO9780511544828.044

Percutaneous coronary intervention (pci) after successful reestablishment of spontaneous circulation and during cardiopulmonary resuscitation. / Noc, Marko; Bendz, Bjorn; Kern, Karl B.

Cardiac Arrest: The Science and Practice of Resuscitation Medicine. Cambridge University Press, 2007. p. 764-771.

Research output: Chapter in Book/Report/Conference proceedingChapter

Noc, M, Bendz, B & Kern, KB 2007, Percutaneous coronary intervention (pci) after successful reestablishment of spontaneous circulation and during cardiopulmonary resuscitation. in Cardiac Arrest: The Science and Practice of Resuscitation Medicine. Cambridge University Press, pp. 764-771. https://doi.org/10.1017/CBO9780511544828.044
Noc M, Bendz B, Kern KB. Percutaneous coronary intervention (pci) after successful reestablishment of spontaneous circulation and during cardiopulmonary resuscitation. In Cardiac Arrest: The Science and Practice of Resuscitation Medicine. Cambridge University Press. 2007. p. 764-771 https://doi.org/10.1017/CBO9780511544828.044
Noc, Marko ; Bendz, Bjorn ; Kern, Karl B. / Percutaneous coronary intervention (pci) after successful reestablishment of spontaneous circulation and during cardiopulmonary resuscitation. Cardiac Arrest: The Science and Practice of Resuscitation Medicine. Cambridge University Press, 2007. pp. 764-771
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