The Cardiovascular Atlas

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$Figure 1. Aberrant conduction. The figure shows a supraventriclar extrasystole (an extra atrial impulse, discharged by an ectopic focus outside of the sinoatrial node). The supraventricular extrasystole arrives into the ventricles while the right bundle branch is still refractory, which is why it blocks the impulse. The resulting QRS-complex has a right bundle branch block pattern.$

Aberrant ventricular conduction

Abnormal Global Longitudinal Strain (GLS), left ventricle, left atrium, abnormal tissue doppler imaging (TDI)

Action potentials

ECGs showing acute STEMI in two patients with severe chest pain. STEMI = ST elevation Myocardial Infarction.

Acute STEMI (ST elevation myocardial infarction)

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Alternative lead systems

Anatomy of the mitral valve

Anterior STEMI with late presentation

Antiplatelet therapy in acute coronary syndromes (NSTEMI, STEMI, UA)

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Antithrombotic Regimens in Patients with ACS and an Indication for Oral Anticoagulation

Antithrombotic Regimens in Patients with ACS without an Indication for Oral Anticoagulation

Aortic regurgitation (AR), severe, infective endocarditis

Aortic stenosis (AS) and mitral stenosis (MS) secondary to radiation therapy

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CVD Atlas

Reperfusion strategy in acute ST elevation acute myocardial infarction (STEMI)

Dr Araz Rawshani, MD, PhD

Associate professor Department of Cardiology, Sahlgrenska University Hospital, Sweden Institute of Medicine, Department of Molecular and Clinical Medicine, Gothenburg, Sweden

More by Dr Araz Rawshani, MD, PhD

Reperfusion therapy is recommended in all patients with a working diagnosis of STEMI (persistent ST-segment elevation or equivalents) and symptoms of ischaemia of ≤12 h duration. (I, A)

Primary PCI
For symptom duration of 0 hours to 12 hours:

PPCI is recommended if the time to wire passing is less than 120 minutes (class Ia).
PPCI is also recommended (class Ic) in unstable patients, including those with recurrent ventricular arrhythmias.

For symptom duration of 12 hours to 48 hours:

PPCI should be considered (class IIa), irrespective of symptoms.

Fibrinolysis: Fibrinolysis is recommended if the time to wire passing is greater than 120 minutes (class Ia) and symptom duration is <12 hours.