Related Experiment Video

Updated: Oct 6, 2025

Author Spotlight: Enhancing Coronary Artery Revascularization
05:25

Author Spotlight: Enhancing Coronary Artery Revascularization

Published on: September 15, 2023

890

Putting the 2021 ACC/AHA/SCAI Guideline for Coronary Artery Revascularization Into Practice: A Case Series

John A Bittl1, Sripal Bangalore2, J Michael DiMaio3

  • 1Cardiac Catheterization Laboratory, AdventHealth Ocala, Ocala, Florida, USA.

JACC. Case Reports
|January 17, 2022
PubMed

Insights

This study demonstrates applying the 2021 ACC/AHA/SCAI guideline to choose between revascularization and optimal medical therapy for stable ischemic heart disease patients. It aids in reducing mortality and cardiovascular events in complex coronary disease cases.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Clinical Guidelines

Background:

  • Stable ischemic heart disease (SIHD) with complex coronary artery disease (CAD) presents treatment challenges.
  • The 2021 ACC/AHA/SCAI guideline offers a framework for revascularization decisions.
  • Left ventricular (LV) dysfunction is a critical factor in SIHD management.

Observation:

  • This case series evaluates the practical application of the 2021 guideline in clinical decision-making.
  • The focus is on selected patient subsets with SIHD and complex CAD.
  • Assessment includes patients with and without LV dysfunction.

Findings:

  • The guideline facilitates choosing between percutaneous coronary intervention (PCI) or optimal medical therapy (OMT).
  • This approach aims to reduce mortality and major adverse cardiovascular events (MACE).
  • The series highlights successful application in specific patient profiles.

Implications:

  • The findings support the guideline's utility in optimizing SIHD patient care.
  • This decision-making process can lead to improved patient outcomes.
  • It provides a structured approach for interventional cardiologists and clinicians.

Keywords:
BP, blood pressureCABG, coronary artery bypass graftCAD, coronary artery diseaseEF, ejection fractionLAD, left anterior descending arteryLM, left mainLV, left ventricularMT, medical therapyMV, multivesselPCI, percutaneous coronary interventionRCA, right coronary arterySIHD, stable ischemic heart diseaseclinical practice guidelinescoronary artery bypass surgeryleft mainleft ventricular dysfunctionmultivessel coronary artery diseasepercutaneous coronary intervention

More Related Videos

Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function10:28

Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function

Published on: March 15, 2022

5.3K
Direct Re-implantation of Left Coronary Artery into the Aorta in Adults with Anomalous Origin of Left Coronary Artery from the Pulmonary Artery ALCAPA13:10

Direct Re-implantation of Left Coronary Artery into the Aorta in Adults with Anomalous Origin of Left Coronary Artery from the Pulmonary Artery ALCAPA

Published on: April 24, 2017

18.7K

Related Concept Videos

Coronary Artery Disease V: Interprofessional Care01:27

Coronary Artery Disease V: Interprofessional Care

Interprofessional care for coronary artery disease includes pharmacological therapy and revascularization procedures.Pharmacological therapy for Coronary Artery Disease (CAD) aims to manage symptoms, prevent complications, and improve patient outcomes through various classes of medications:Antiplatelet Agents:Aspirin and Clopidogrel: These medications inhibit platelet aggregation, preventing blood clots, which is crucial for avoiding heart attacks and strokes. Doctors often prescribe these...
58
Acute Coronary Syndrome IV: Interprofessional Care01:28

Acute Coronary Syndrome IV: Interprofessional Care

IntroductionThe management of Acute Coronary Syndrome (ACS) aims to minimize myocardial damage, preserve myocardial function, and prevent complications.Initial ManagementInpatient management involves continuous cardiac monitoring, preferably in an ICU, focusing on blood pressure, serum sodium, potassium, and creatinine levels, and urine output. Ongoing pharmacologic management is crucial for stabilizing the patient.Supplemental Oxygen: Administer supplemental oxygen if oxygen saturation is...
46
Acute Coronary Syndrome V: Nursing Management01:26

Acute Coronary Syndrome V: Nursing Management

Nursing Assessment:Nursing management of acute coronary syndrome (ACS) involves taking the patient's history, focusing on primary complaints such as chest pain, dyspnea, and excessive sweating (diaphoresis), as well as other symptoms like back or jaw pain, nausea, vomiting, palpitations, dizziness, and fatigue. The nurse also reviews the patient's history of cardiac events, risk factors such as hypertension, diabetes, smoking, family history, and current medications.In the objective assessment,...
60
Acute Coronary Syndrome III: Diagnostic Studies01:30

Acute Coronary Syndrome III: Diagnostic Studies

Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
40
Acute Coronary Syndrome I: Introduction01:30

Acute Coronary Syndrome I: Introduction

Acute Coronary Syndrome (ACS) encompasses a spectrum of heart conditions caused by sudden obstruction of coronary arteries, typically resulting from the rupture of an atherosclerotic plaque and subsequent thrombus (blood clot) formation. This obstruction can lead to partial or complete blockage of blood flow, causing varying degrees of myocardial ischemia or infarction.ACS includes the following clinical entities:Unstable Angina (UA)Non-ST-Elevation Myocardial Infarction (NSTEMI)ST-Elevation...
108
Coronary Artery Disease IV: Preventive Measures01:26

Coronary Artery Disease IV: Preventive Measures

Effective preventive measures for coronary artery disease (CAD) focus on controlling modifiable risk factors, including cholesterol abnormalities and lifestyle changes.Cholesterol ManagementFirst, the Mediterranean diet and the American Heart Association advocate for maintaining low-density lipoprotein (LDL) cholesterol levels below 100 mg/dL, with a more stringent recommendation of below 70 mg/dL for individuals at high risk. LDL cholesterol, often termed "bad cholesterol," can lead to the...
208