Young_Heart_Attacks_Module3_ER_Intervention.pptx

heart attcks in young

1. Young Heart Attacks & Cardiac Arrest – Module 3 Emergency Response & Interventional Management

2. Out-of-Hospital Cardiac Arrest (OHCA) India: survival rates <5% Bystander CPR rates <10% Contrast: developed countries achieve 20–30% survival

3. CPR Gap – India vs Target

4. Chain of Survival Early recognition Call for help CPR initiation Defibrillation with AED Advanced/post-arrest care

5. Role of AEDs AED use improves survival 2–3× Placement: gyms, malls, airports, campuses Dispatcher-assisted CPR programs crucial

6. Hospital Role in Post-Arrest Care Therapeutic hypothermia (TTM) Rapid cath lab access Post-arrest ICU care Neurological recovery protocols

7. STEMI in the Young – Management Primary PCI preferred strategy Thrombolysis only if PCI not available Secondary prevention: intensive risk factor control

8. NSTEMI & MINOCA NSTEMI in young: often associated with smoking, stress MINOCA: myocarditis, vasospasm, microvascular dysfunction OCT/CMR can aid diagnosis

9. Why Metal-less PCI in the Young? Lifelong caging of coronaries problematic Future reinterventions more complex with DES BRS allows 'leave nothing behind' strategy

10. Bioresorbable Scaffolds (BRS) ABSORB IV: excess events ≤3y, but similar outcomes after 5y MeRes100 (India): encouraging mid-term data Magnesium-based scaffolds (Magmaris/DREAMS 3G) promising

11. BRS vs DES Outcomes

12. Calcium Modification Techniques IVL: safe and effective for deep calcium (DISRUPT CAD) Rotablation: high-speed burr for calcified lesions Orbital atherectomy: alternative tool IVUS/OCT guidance essential

13. Role of IVUS & OCT IVUS: vessel sizing, stent expansion, MLA/MSA criteria OCT: plaque morphology, stent edge dissections Improves outcomes when used systematically

14. Post-PCI Considerations in the Young Dual antiplatelet therapy adherence crucial Bleeding risk vs ischemic risk balance Aggressive lifestyle modification to prevent recurrence

15. Module 3 Summary OHCA survival in India is poor → CPR & AED expansion needed Primary PCI is treatment of choice for young STEMI Bioresorbable scaffolds offer future potential IVUS/OCT guidance improves interventional outcomes Calcium modification and optimal stent expansion critical