Imaging provides a more precise diagnosis of a heart attack that can be used to individualise treatment.
Imaging provides a more precise diagnosis of a heart attack that can be used to individualise treatment. That’s the main message of an expert consensus paper published today in European Heart Journal, a journal of the European Society of Cardiology (ESC), and presented at EuroPCR in Paris, France.
Heart attacks are diagnosed and treated using coronary angiography, an invasive procedure which provides an X-ray outline of the arteries supplying blood to the heart. Invasive imaging of the arteries gives more detail but there has been controversy over when to use it.
This document seeks to resolve that debate. It promotes the adoption of intracoronary imaging in two major areas: 1) acute coronary syndromes including heart attack and 2) when diagnostic information from angiography is unclear.
Which patients and lesions merit imaging? For acute coronary syndromes, advice is given on atypical presentation, complex lesions, and non-obstructive coronary artery disease. The paper provides criteria for assessment of the arteries, interpretation of images, choice of treatment, and guidance during stent insertion (percutaneous coronary intervention; PCI). In the past it was thought that most acute coronary syndromes were caused by ruptured plaque. Intracoronary imaging has identified plaque erosion and eruptive calcified nodules as other causes which may benefit from different treatment. In addition, intracoronary imaging clearly shows thrombus, which angiography may miss or misidentify.
Read more at European Society of Cardiology
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