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Dr. Sreenivas Kumar: Management Of STEMI In The Absence Of PCI

Less than 5 to 10% of the PCI facilities cater to tier 2 and tier 3 cities
Dr.Sreenivas Kumar, Chief Cardiologist at Citizens Hospitals in Hyderabad on A Protocol for PCI and Non-PCI enabled center to follow when they have to transfer the patient to a  PCI Center.
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Dr. Sreenivas Kumar

Chief Cardiologist

Citizens Hospital, Hyderabad


“Though cath lab numbers have been increasing in India, they are unevenly distributed. Majorly concentrated in the tier 1 cities, less than 5 to 10% of these facilities cater to tier 2 and tier 3 cities,” Dr. Sreenivas Kumar says in an interview with Dr. Manish Verma.Most of the myocardial damage can be avoided if the artery can be opened and re-perfused in the first three hours. But less than 4% of the total population which suffers acute MI gets a primary PCI. To buy some time, reperfusion with thrombolytic drugs is the second best option. Newer thrombolytic agents like tenecteplas are more fibrin specific, less complication prone and have better opening rates than the old streptokinase.“After thrombolysis, once the rhythm abnormality settles and BP becomes stable, then patients are in a better shape to be shifted to PCI centres.”“When people are presented to a PCI center after thrombolytic therapy, 50% do not need any further procedure, because the artery is already open.”Usage of high dose statins and newer antiplatelets like ticagrelor and prasugrel is also recommended. With that, diagnosis of MI is the only problem remaining. To solve it, Dr. Sreenivas suggests that every physician must pair up with a cardiologist, so that ECG readings can be transmitted and confirmation regarding acute MI can easily be obtained.In a parallel conversation, Dr. Sreenivas warns that any symptom of a heart attack like chest pain must not be neglected by presumption of acidity or gas to be the reason. “There is no reason to not treat it as a cardiac problem unless proven otherwise,” he adds.Many issues of the dual antiplatelet therapy are also extensively discussed by Dr. Sreenivas Kumar.


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Could handheld echocardiography replace a stethoscope?

Dr. Hardeep Kaur

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Dr. Hardeep Kaur

Consultant clinical and preventive cardiology

Medanta, The Medicity


Handheld echocardiography cannot really replace a stethoscope but it can definitely help in an emergency for ruling in and ruling out cardiac involvement. Therefore, helps in quick clinical decision making and also reduces the chances of doing unnecessary tests.


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Recent Advances in Echocardiography and their impact on clinical practice

Dr. Navin C Nanda

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Dr. Navin C Nanda

Director of Echocardiography

University of Alabama, USA



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Echo with telemedicine creates a multiple effect

CAD affects 10%of our population over 40 years

Dr. Sameer Srivastava

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Dr. Sameer Srivastava

Head of Non-invasive Cardiology

Fortis Escorts Heart Institute, New Delhi



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