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Rotational Atherectomy

Abstract

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Effect of orbital atherectomy in calcified coronary artery lesions as assessed by optical coherence tomography In vivo comparison of lipid-rich plaque on near-infrared spectroscopy with histopathological analysis of coronary atherectomy specimens Incremental Prognostic Value of Guideline-Directed Medical Therapy, Transradial Access, and Door-to-Balloon Time on Outcomes in ST-Segment-Elevation Myocardial Infarction State of the art: evolving concepts in the treatment of heavily calcified and undilatable coronary stenoses - from debulking to plaque modification, a 40-year-long journey Rotational atherectomy and new-generation drug-eluting stent implantation Optical frequency-domain imaging findings to predict good stent expansion after rotational atherectomy for severely calcified coronary lesions Short-term and long-term clinical outcomes of rotational atherectomy in resistant chronic total occlusion Radial Versus Femoral Access for Rotational Atherectomy: A UK Observational Study of 8622 Patients
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Perspective

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IABP, a Solution for Cardiogenic Shock Complicating Acute Myocardial Infarction?

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Pre-reading

Cardiogenic shock is a condition in which your heart suddenly can't pump enough blood to meet your body's needs. Cardiogenic shock is rare, but it's often fatal if not treated immediately. If treated immediately, about half the people who develop the condition survive.


Symptoms

Cardiogenic shock signs and symptoms include:

  • - Rapid breathing
  • - Severe shortness of breath
  • - Sudden, rapid heartbeat (tachycardia)
  • - Loss of consciousness
  • - Weak pulse
  • - Low blood pressure (hypotension)
  • - Sweating
  • - Pale skin
  • - Cold hands or feet
  • - Urinating less than normal or not at all


Because cardiogenic shock usually occurs in people who are having a severe heart attack, it's important to know the signs and symptoms of a heart attack. These include:

  • - Pressure, fullness or a squeezing pain in the center of your chest that lasts for more than a few minutes
  • - Pain extending to your shoulder, one or both arms, back, or even to your teeth and jaw
  • - Increasing episodes of chest pain
  • - Shortness of breath
  • - Sweating
  • - Lightheadedness or sudden dizziness
  • - Nausea and vomiting


Causes

In most cases, a lack of oxygen to your heart, usually from a heart attack, damages its main pumping chamber (left ventricle). Without oxygen-rich blood circulating to that area of your heart, the heart muscle can weaken and go into cardiogenic shock.

Rarely, damage to your heart's right ventricle, which sends blood to your lungs to receive oxygen, leads to cardiogenic shock.

Other possible causes of cardiogenic shock include:

  • - Inflammation of the heart muscle (myocarditis)
  • - Infection of the heart valves (endocarditis)
  • - Weakened heart from any cause
  • - Drug overdoses or poisoning with substances that can affect your heart's pumping ability


Risk factors

If you have a heart attack, your risk of developing cardiogenic shock increases if you:

  • - Are older
  • - Have a history of heart failure or heart attack
  • - Have blockages (coronary artery disease) in several of your heart's main arteries
  • - Have diabetes or high blood pressure
  • - Are female


Contemporary treatment strategy of cardiogenic shock complicating acute myocardial infarction are linked on the right side.



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