Myocardial Ischaemia National Audit Project - University College ...

Coronary thrombosisThe formation of a blood clot one of the arteries carrying bloodto the heart muscle.Contractile functionThe ability of the heart to pump blood.Contractile dysfunction/HypocontractilityA decline in pumping action of the heart where contractionis inefficient and unable to adequately supply oxygen andnutrients to body organs.Door-to-balloon (DTB) timeThe interval between the ambulance arriving at a hospital andthe performance of primary angioplasty.Door-to-needle (DTN) timeThe interval between the ambulance arriving at a hospital andthe administration of thrombolytic therapy.ElectrocardiogramAlso known as ‘ECG’. A test to record the rhythm and electricalactivity of the heart. The ECG can often show if a person has hada heart attack, either recently or some time ago. It can also tellif reperfusion therapy is appropriate and if it has been effective.EchocardiographyA test that uses sound waves to create moving pictures ofthe heart. The pictures show the size and shape of theheart, pumping capacity and the location and extent of anytissue damage.Heart attackThe term applied to the symptoms, usually but not alwaysinvolving chest pain, which develop when a clot (thrombus)develops within a heart artery as a result of spontaneousdamage to the inner lining of the artery (plaque rupture).The heart muscle supplied by the blocked artery sufferspermanent damage if the blood supply is not restored quickly.The damage to heart muscle carries a risk of sudden death,and heart failure in people who survive.Heart Attack CentreA hospital that provides coronary interventions for patientswith acute coronary syndromes.Heart failureHeart failure occurs when a damaged heart becomes lessefficient at pumping blood round the body. This may resultfrom damage to the heart muscle caused by a heart attack.There are typically symptoms of breathlessness with exertionand, later, swelling (oedema) of lower limbs.IQRInterquartile range; the value at 25% and 75% of an orderedset of values.Left ventricleThe left lower chamber of the heart that receives oxygenatedblood from the left atrium and pumps it out under highpressure through the aorta to the body.MedianThe number falling in the middle of a ranked series ofnumbers.Myocardial infarctionA heart attack in which heart muscle damage is confirmed byblood testing.NecrosisA form of cell injury that results in the death of cells inliving tissue.Non-ST elevation myocardial infarction (nSTEMI)A heart attack that occurs in the absence of ST segmentelevation on the ECG. In these patients urgent admission tohospital is mandated but immediate reperfusion therapy isnot required.PericarditisInflammation of the outer sac that surrounds the heart. Whenpericarditis occurs, the amount of fluid between the two layersof the pericardium increases. This increased fluid presses onthe heart and restricts its pumping action.Pre-hospital thrombolysisThrombolytic treatment given before arrival in hospital, usuallyin the ambulance by paramedics. This saves time in providingtreatment and is used with longer journey times.Primary percutaneous coronary intervention (PCI)A technique to re-open the blocked coronary arteryresponsible for the heart attack. A fine catheter (tube) ispassed, under local anaesthetic, from an artery in the leg orarm into the blocked heart artery. A small inflatable balloonis then passed through the catheter and across the blockage,allowing the artery to be re-opened by temporary inflation ofthe balloon. This part of the technique is called angioplastyand when used as the initial treatment for heart attack canbe referred to as ‘primary angioplasty’. Following opening ofthe artery, this is normally kept open by a small expandablemetal tube (stent) whichis passed into the arterywith the angioplastyballoon. The umbrellaterm that encompassesboth balloon dilatation(angioplasty) and stentinsertion (stenting) is‘percutaneous coronaryintervention’ (PCI).MINAP Eleventh Public Report 2012 103