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Old 08-23-2011
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Default Q about cardiac catheterization vs angioplasty

I have a question about this case :

55 y/o lady p/w chest pain. 3 hours. Was given Ox, aspirin, GTN, Beta blockers.

ECG showed inverted T-waves in leads II, III and aVF.

My questions regarding this case are :
1) Does the inverted T-waves signify that she has NSTEMI, instead of unstable angina?
2) Would you do cardiac catheterization in this woman?
3) The answers in the question also lists angioplasty. Isn't cardiac cath and angioplasty sort of the same thing? (just that the latter is the therapeutic part of it?)
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Old 08-23-2011
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1. No, inverted t waves do not signify NSTEMI. only thing that can differentiate btw unstable angina and NSTEMI is cardiac enzymes...if elevated, NSTEMI n if normal unstable angina ( any ST-Tchanges other than elevation can be found in both)

2. yes u can do cath, but then again firstly u ll get cardiac enzymes to reach a diagnosis...

As far as cath or angigraphy is concerned, it can b done in any CAD but timing n urgency is different
  • STABLE ANGINA: cath is done if noninvasive stress tests are containdicated, inadequate for diagnosis or if noninvasive tests are positive to plan angioplasty or CABG
  • UNSTABLE ANGINA/ NSTEMI: early cath within 48 hrs to plan further management, or even early if pain is not settled
  • STEMI: chest pain for less than 12 hrs, PCI within 90min or thrombolysis within 30min. Here cath is done for reperfusion purposes mainly n not diagnosis.
3. yes cardiac cathertrization is a general term for a group of procedures performed by this method, including angiography, angioplasty, septostomy, ventriculography etc...but in general when it is used in refernce with CAD, it commonly refers to angiography. n if they want to mention a specific therapeutic procedure done by cath, they mention it by its specific name..(as u said angioplasty was separately given in the options)
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The above post was thanked by:
Ace3 (08-23-2011), busterbee (08-23-2011), cerebrum85 (08-23-2011), doctorsmonsters (08-23-2011)


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