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Emergency Percutaneous Coronary Intervention in Mukundapur

Emergency Percutaneous Coronary Intervention (PCI)

Emergency Percutaneous Coronary Intervention (PCI) Mukundapur

Arteries are blood vessels that supply oxygen-rich blood throughout the body. When a fatty or waxy substance builds up within the blood vessels, it can have severe health implications, such as a heart attack. An individual with a heart attack or chest pain (angina) might need emergency PCI if they are not responding to other treatment options.

Percutaneous Coronary Intervention, formerly known as Coronary Angioplasty, is a procedure to clear blocked arteries. The procedure involves using a small balloon to reopen the blocked artery. A medicated or non-medicated stent might be placed in the re-opened artery to preserve its patency.

Emergency Percutaneous Coronary Intervention PCI is a safe procedure that improves your symptoms associated with heart blockage and has minimal risks. The treatment is minimally invasive and requires a shorter recovery time. However, you must take precautions to reduce the risk of future blocks.

FAQ's

Clinical indications for PCI interventions are:

  • Acute ST-elevation myocardial infarction (STEMI)

  • Primary PCI is recommended when the procedure can be performed promptly by an experienced professional.

  • STEMI and ischemic symptoms lasting less than 12 hours.

  • STEMI and ischemic symptoms of less than 12 hours and contraindication to fibrinolytic therapy.

  • Patients with significant stenosis (greater than 50%)

  • Non-ST elevation acute coronary syndrome

  • Early intervention within two hours of symptom development is advised for patients with refractory angina, recurrent angina, and heart failure

  • Worsening of troponin levels requires early intervention with PCI

  • Other indications for PCI are:

  • Angina pectoris (stable or unstable)

  • Myocardial ischemia

  • Acute myocardial infarction

  • Sudden cardiac arrest

  • Non-invasive heart tests reveal reduced blood flow to the heart

  • Absolute complications
  • Non-compliance with the procedure or inability to take dual antiplatelet therapy.
  • High bleeding risk or presence of bleeding disorders
  • Multiple percutaneous coronary intervention restenosis
  • Relative contraindication
  • High-grade chronic kidney disease
  • Intolerance for oral anti-platelets
  • An artery with less than 1.5 mm diameter
  • Stenosis of more than 50%

STEMI is both a structural and functional heart issue. The characteristics of the condition include an occluded coronary artery and myocardial necrosis. Therefore, rapidly achieving normal coronary artery flow both at micro and macrovascular levels with emergency PCI helps prevent the progression of myocardial necrosis. The percutaneous intervention and stent placement must be performed within 90 minutes of pain onset for optimal results in STEMI patients.
 

Since the procedure is performed on an emergency basis, you will not need any preparation. As you are taken to the operating room, you will be administered general anaesthesia. 

During the procedure, a small hollow tube will be inserted through the blood vessel in your arm or upper thigh (preferably the femoral, radial, or brachial artery). A catheter is guided through this hollow tube into the affected heart vessels. A contrast dye and X-ray imaging are employed to view the catheter in real time.

After locating the blocked artery, the balloon at the tip of the catheter is inflated. This helps dislodge the plaque and dilate the artery; a stent may be placed to prevent the artery from becoming narrow. After the stent placement, the catheter is removed and the incision site is closed. The procedure may take 30 minutes or more, depending on the extent of the block. The procedure facilitates the clearance of 2 or 3 blocks in one procedure.
 

You may experience slight discomfort around the catheter insertion site. Also, you should be mindful of any unusual pain, bleeding, or discolouration. 

After discharge, keep the insertion clean and dry. Notify your healthcare practitioner right away if you experience any unusual symptoms. Medications may be prescribed to you, which you must continue taking as per your doctor’s instructions.
 

PCI is a life-saving procedure for STEMI patients and can improve their survivability when performed within the appropriate period. 
 

The procedure is life-saving in emergencies. It helps alleviate symptoms such as chest pain or shortness of breath caused by blocked arteries. Blood flow to the heart muscle is restored, and the patients can function better and remain symptom-free for a long time. Sometimes the artery can become narrow again, but advancements in stent technology mean the chances of this happening are becoming lower.
 

Emergency PCI procedures have a greater risk of developing complications. Some of the risks include:

  • Bleeding or infection at the catheter insertion site

  • Blood clots in the heart stents

  • Kidney-related complications due to the use of the dye

  • Re-narrowing of the artery

  • Heart attack

  • Stroke

  • Death 

You may resume your normal routine within one week of undergoing the procedure. However, doctors advise you to avoid strenuous activities or to lift heavy objects. You may have to take blood-thinning medications for life to prevent the risk of developing blood clots.
 

You might need to manage the following:

  • Medications: Individuals who have undergone a PCI procedure with stent placement may have to take an antiplatelet for life.

  • Take care of the catheter insertion site.

  • Diet and lifestyle modifications.

  • Undergo cardiac rehabilitation, if necessary.

You will have to contact your healthcare provider immediately if you experience the following:

  • Bleeding or pus discharge at the catheter insertion site

  • Chills or fever

  • Chest pain

  • Dizziness or fainting

  • Shortness of breath

  • Swelling that does not go away

A PCI procedure is only recommended if the doctor feels it is the best option to treat your heart disease or symptoms. If PCI is not feasible, you may be advised to seek medical therapy or Coronary Artery Bypass Graft Surgery.
 

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