00:01
Ok, this question says, david, a 55 -year -old high school teacher, is a heavy smoker with really poor eating habits.
00:08
He was admitted to the emergency room a week ago because he was experiencing symptoms including shortness of breath, chest pain, weakness in his left arm and left leg.
00:18
He was rushed to the coronary care unit where clinicians performed ecg and arteriogram tests.
00:25
The results showed 80 % occlusion of the left main coronary artery.
00:40
It says, what conditions does he have? you have dilated cardiomyopathy, atherosclerosis, myocardial infarction, and bronchial arrhythmia or endocarditis.
00:53
According to all of the findings that they have given us, the answer is going to be option c, that is myocardial infarction.
01:05
So the symptoms this patient is experiencing, like for example dyspnea, that is shortness of breath, chest pain, and weakness in his left arm and leg, are all signs of heart attack, that is the same as myocardial infarction.
01:19
The ecg and arteriogram test confirmed that he has 80 % occlusion of the main coronary artery.
01:26
So if this is your left main coronary artery that is going to supply the myocardium, remember the myocardium, normally this left main coronary artery is going to branch into many other branches, for example the left descending artery, the circumflex artery, and they are going to supply blood to specific areas of the heart, of the myocardium specifically.
01:49
But if you block here, then this is going to be very severe because you're not blocking this branch here or this branch here, you're blocking the main branch.
02:00
So practically both of these branches are going to be affected, so this is very severe.
02:06
So practically this is a major cause of heart attack, obstruction of the coronary artery segment or the main coronary artery.
02:15
And this occlusion is most commonly caused by atherosclerosis, there is a buildup of plaque in the artery walls due to factors such as smoking or poor diet.
02:26
Dilated cardiomyopathy, cardiac arrhythmia, and endocarditis are all different conditions that can cause heart problems, but they don't match the symptoms and test results that david is experiencing.
02:36
The next question says, which treatment is david most likely to receive for his condition? well, the main goal of treatment for myocardial infarction is to restore blood flow to the affected area of the heart and prevent further damage to the heart muscle.
02:55
In most cases, the initial treatment will involve administering medications, for example, such as aspirin, also nitroglycerin, and also heparin, okay? in order to prevent blood clots, relieve pain, and improve the blood flow.
03:19
David may also receive thrombolytic therapy or undergo a procedure called angioplasty, okay? where a catheter with a small balloon is inserted into the blocked artery and inflated to open up the blockage, following the placement of a stent to keep the artery open, okay? so you're going to place here a catheter with a balloon, and this balloon is going to expand here in order to dilate or to relieve practically the obstruction, okay? so this is called here angioplasty, but this angioplasty is usually done when there is a specific interval of time.
04:11
It means since the patient or practically there is something called a door -to -balloon time, okay? that is a measure of the time it takes from a patient's arrival at the hospital to the time they receive percutaneous coronary intervention.
04:26
That is practically this process of angioplasty, okay? so this time here is very important because the longer it takes to perform the angioplasty, the greater the risk of permanent heart damage or even death...