Management of ACS for the ALS Provider

Percutaneous Coronary Intervention (PCI)

PCI is the primary therapeutic procedure for a majority of patients who present with a STEMI.  PCI is when the inflation of a balloon within the damaged or occluded coronary artery crushes the plaque into the walls of the artery.  Patient dependent, a small mesh tube called a stent is placed into the injured artery to maintain patency.

Coronary reperfusion with primary percutaneous coronary intervention (PPCI) or fibrinolytic therapy improves outcomes in patients with acute ST elevation MI (STEMI) or an MI with a new or presumably new left bundle branch block or a true posterior MI. If performed in a timely fashion, PPCI is the reperfusion therapy of choice compared to fibrinolysis and does not carry the risk of intracranial hemorrhage.  It is also associated with improved outcomes. [13-15]