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STEMI with shock ,now pain better but on inotropes.. EF 20% Plan ? 1.Wait for stabilization & ONLY CABG 2.IABP +LAD PCI & staged later 3.IABP + RCA CTO & LAD PCI same sitting #CardioTwitter Mamas A. Mamas Hany Ragy MIЯVΛƬ #IC ༄ ｡° Dr Imran Hanif Hashmi akbar... show more

Abad khan,MD/DM

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22,494 views • 3 years ago •via X (Twitter)

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9 Comments

MIЯVΛƬ #IC3 years ago

Shocked patients generally don’t do well w a wait n watch strategy A minority of STEMI/CS undergo CABG in view of a persistently high operative risks & death rate (figure) MCS & PCI is a more widely available option & this is a comprehensive review of the topic ⤵️ @HenrytTimothy @SVRaoMD @thiele_holger @HollandTamis et al

Abad khan,MD/DM3 years ago

@mmamas1973 @Hragy @DrIHHashmi1 @akbarul @Obisht @DrAnkushG @cardiodoc1988 Amazing

Khalid Minhas, MD FACC3 years ago

@mmamas1973 @Hragy @mirvatalasnag @DrIHHashmi1 @akbarul @Obisht @DrAnkushG @cardiodoc1988 In STEMI and shock the best chance we have is to open the culprit vessel STAT and use LV support as needed/available

Abad khan,MD/DM3 years ago

@mmamas1973 @Hragy @mirvatalasnag @DrIHHashmi1 @akbarul @Obisht @DrAnkushG @cardiodoc1988 Homogeneous answers across I.C community in CHIP cases what we/i do keeps me/us aligned & path correction if and Whenever wrong decision is taken .. IABP , LAD DES post dilated with 4.0 ..better now

Rakan I. Nazer راكان بن ابراهيم ناظر3 years ago

@mmamas1973 @Hragy @mirvatalasnag @DrIHHashmi1 @akbarul @Obisht @DrAnkushG @cardiodoc1988 Not great targets for CABG except LAD and possibly OM. Generally early CABG if the presentation is within 6hrs from the onset of symptoms. Otherwise better to temper with IABP and have a discussion with the heart team.

John A. Fry MD, FACC, FSCAI3 years ago

@mmamas1973 @Hragy @mirvatalasnag @DrIHHashmi1 @akbarul @Obisht @DrAnkushG @cardiodoc1988 Fix LAD. Mechanical support (Impella preferred if available). Pulmonary catheter. Staged PCI of Cx.

Hany Ragy3 years ago

@mmamas1973 @mirvatalasnag @DrIHHashmi1 @akbarul @Obisht @DrAnkushG @cardiodoc1988 Important question, why is the LVEF 20%? The anatomy here doesn’t explain that. Can u please put the ECG, what kind of STEMI?

Abad khan,MD/DM3 years ago

@mmamas1973 @mirvatalasnag @DrIHHashmi1 @akbarul @Obisht @DrAnkushG @cardiodoc1988 RCA -100% LARGE LCX-OM 100% LAD was probably 100% too , got some TIMI-2 flow due to loading doses of antiplatelets + I.V heparin and I.V Bolus GP2b3a he received likely before he entered CATH LAB ( significant GRADE 4 residual thrombus still..(poor film today) 1st ECG @ midnight

Dr. A. Murshid الدكتور/ عبدالإله عبدالرحمن مرشد3 years ago

@mmamas1973 @Hragy @mirvatalasnag @DrIHHashmi1 @akbarul @Obisht @DrAnkushG @cardiodoc1988 No CABG, Cuz, risky& not yielding &won't tolerate X-clamp without devices ,nor manipulation of off pump.Not to mention poor recovery from Sx w' preop EF 20%&CHf require inotrop,I doubt you w' improve survival rather quality of life. I vote for :2.IABP +LAD PCI & staged later

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39,661 views • 3 years ago

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18,785 views • 2 years ago

7 months ago after meeting 2 Cardiology giants Mamas A. Mamas Hany Ragy & seeing their fitness, i felt i was too unhealthy & may be was giving hollow advices to my patients for healthy practices if i couldn't follow it on myself .. Changed the game ..From BMI of 31.4 to BMI of 26.2

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54,669 views • 3 years ago