No abstract

Surviving a Left Main coronary artery (LMCA) total occlusion depends upon the presence of well-developed collaterals. We report a 44 year male patient, with past history of Ischemic heart disease, who underwent Angioplasty to Left Anterior Descending Artery (LAD) in 2009, and presented with Acute Coronary Syndrome (ACS)-Non ST Elevation of Myocardial Infarction (NSTEMI). Subsequently, cardiac catheterization revealed a total occlusion of the LMCA with dominant right coronary artery (RCA) giving collaterals to the left coronary arteries. The patient was immediately referred for coronary artery bypass surgery (CABG) and was symptom free on follow up. This case demonstrates the power of collateral circulation in protecting the patient from symptoms and death despite total occlusion of the LMCA.

No abstract

2017-08-25T16:27:58

There have been no published recommendations for the management of low-risk chest pain in emergency departments (EDs) across India. This is despite the fact that chest pain continues to be one of the most common presenting complaints in EDs. Risk stratification of patients utilizing an accelerated diagnostic protocol has been shown to decrease hospitalizations by approximately 40% with a low 30-day risk of major adverse cardiac events. The experts group of academic leaders from the Indian College of Cardiology and Academic College of Emergency Experts in India partnered with academic experts in emergency medicine and cardiology from leading institutions in the UK and USA collaborated to study the scientific evidence and make recommendations to guide emergency physicians working in EDs across India.