IBCC Episode 126 - Myocardial Ischemia

The Internet Book of Critical Care Podcast

Adam Thomas

Foam, Medicine, Health & Fitness, Science, Criticalcare, Medicaleducation

5 • 714 Ratings

🗓️ 2 December 2022

⏱️ 55 minutes

🔗️ Recording | iTunes | RSS

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Summary

Annnnnnnnd We are back. Sorry, but after Andor has finally finished we have now got time to discuss the old type 1 MI, aka STEMI aka Occlusive Myocardial Infarction. Come listen for all those basics and some nuances around myocardial infarction in critically unwell patients. We talk when to DAPT, who gets full anticoagulation, hemodynamic support, and when to wake our Cardiology friends up in the night.

Transcript

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0:00.0	All right, welcome back to the Internet Book of Critical Care podcast.
0:09.0	I'm here with Adam Thomas, and we're going to talk about type 1 myocardial infarction or spontaneous plaque rupture, am I?
0:15.2	Josh, it's been a couple months.
0:16.7	It's been a minute.
0:17.9	Before we talk about breaking hearts, can we just say my heart misses you, man?
0:21.9	Yeah, it's been way too long.
0:23.2	It's been too long.
0:24.2	Sorry, everyone, I am the chink in his armor, but we're back at it.
0:28.8	It's not your fault.
0:29.6	The university is killing Adam, and yeah, it's problematic.
0:32.2	We're all on a slow-burning ship, aren't we, Josh?
0:36.1	Some ships are burning faster than others.
0:38.7	So let's ignore our daily work lives, guys, and let's talk about some medicine for once
0:45.5	and enjoy some good pathophysiology.
0:48.5	So Josh, today, myocardial infarction, it's a big, big thing we talk about every day, right?
0:53.8	Someone comes in, they're super sick,
0:55.2	and somebody did in ECG the night before on admission, and it shows some strain. Maybe the
1:00.9	trope's really high. Do I send them to the cath lab or not? And that's the hallmark of this
1:07.0	chapter and the core of what we're going to get at is how do we manage myocardial
1:11.6	infarction or concerns for it in ICU and more importantly who goes to cath and do we bug
1:16.6	cardiology about and who do you just stop doing triponants on right josh 100% and i think this is a
1:22.5	super challenging chapter to talk about and to write because it spans a huge gamut of patients.
	...

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