Percutaneous Transluminal Coronary Angioplasty

Percutaneous Transluminal Coronary Angioplasty

Question. Write a short note on PTCA.

Answer. Percutaneous transluminal coronary angioplasty (PTCA) is a minimally invasive procedure to open up blocked coronary arteries, allowing blood to circulate unobstructed to the heart muscle.
In PTCA, balloon dilatation of the coronary stenosis is done.

Method: Percutaneous transluminal coronary angioplasty (PTCA)

Procedure of doing PTCA is commenced by passing a guide wire under fluoroscopic control, this wire positions the balloon dilatation centre at level of stenosis, now balloon dilatation of the stenotic segment is carried out to maintain the circulation throughout.

Indications

1. This method provides complete or partial revascularization in cases of stable angina pectoris, unstable angina pectoris or myocardial infarction.
2. It is indicated in patients with recurrent angina after coronary artery bypass grafting (CABG).

Complications Percutaneous transluminal coronary angioplasty (PTCA)

1. Blood vessel occlusion can occur by thrombosis.
2. Recurrent angina pectoris
3. Restenosis can occur.

Question. Write management of atrial firillation.

Answer. It is the most common sustained tachyarrhythmia seen in patients.

Management f atrial firillation.

1. Ventricular rate is reduced by giving digoxin. Digoxin 0.5 mg IV slowly is given. After this, patient is kept on oral digitalis therapy, i.e. 0.25 mg twice daily.
2. Antiarrhythmic drugs such as propranolol is given IV at a rate of 1 mg every 5 min followed by maintenance of oral dose of 20–40 mg three times a day.
3. Underlying causes such as thyrotoxicosis and acute chest infections should be treated to maintain normal sinus rhythm.
4. Anticoagulant therapy should be given in patients with chronic atrial firillation.
5. Defirillation should be done. A DC shock of 100 joules restore normal sinus rhythm.