Myocardial Ischaemia National Audit Project - University College ...

Pulmonary oedemaAn abnormal buildup of fluid in the air sacs of the lungs, whichleads to shortness of breath.QT intervalA measure of the time between the start of the Q wave and theend of the T wave in the heart’s electrical cycle.Re-infarctionThe development of evidence of re-occlusion (furtherblockage) of, or development of blood clot within, the coronaryartery that was responsible for the original heart attack. Thiswould normally occur after the original blockage had beensuccessfully treated.Reperfusion treatmentThe term used to cover both techniques, thrombolytic treatmentand primary PCI, for reopening a coronary artery as anemergency. These treatments are suitable only for certain typesof heart attack characterised by typical electrocardiographicappearances described as ST segment elevation.RevascularisationInterventions that improve the blood supply to the heart,including PCI or coronary artery bypass graftingSecondary prevention treatmentMedication that reduces the risk of further heart attack, or therisk of complications such as heart failure. See aspirin, betablockers, ACE inhibitors and ARBs, clopidogrel and statins.These medications are usually initially prescribed to allpatients who can tolerate them.StatinsDrugs used to reduce cholesterol levels in the blood.ST elevation myocardial infarctionA heart attack characterized by a specific abnormalappearance on the ECG (ST segment elevation) thought to beindicative of complete occlusion of a coronary artery.Thienopyridine inhibitorsAntiplatelet agents, of which clopidogrel and prasugrel arepresently licensed for use. A similar drug, ticagrelor, is alsonow being used in some patients.Thromboembolic complicationsFormation of a clot (thrombus) in a blood vessel that breaksloose and is carried by the blood stream to plug anothervessel. The clot may plug a vessel in the lungs, brain,gastrointestinal tract, kidneys, or leg.Thrombolytic treatmentThe outcome for certain types of heart attack can be improvedby using clot-dissolving (thrombolytic) drugs. Thrombolytictreatment is effective up to about 12 hours after the onset ofsymptoms but is most effective when given very early afterthe symptoms started. Thrombolytic drugs are not givenunless there are typical changes on the electrocardiogram(ECG). As these drugs are designed to dissolve clots, they maybe unsuitable for some patients who are at risk of internalbleeding. Patients at significant risk of bleeding may not begiven this treatment where the risk of bleeding is greater thanany potential benefit. Where this risk exists primary PCI maybe an effective alternative.ThrombusA blood clot, the development of which is known a thrombosis.VentriculographyA medical imaging test used to determine a patient’s cardiacfunction which involves an injection of a dye that shows up onX-rays, into the heart’s ventricles to measure the volume ofblood pumped.Appendix 4: MINAP Publications1999Rickards A, Cunningham D. From quantity to quality: the centralcardiac audit database project. Heart 1999;82: 1118-1122Birkhead JS, Norris RM, Quinn T et al. Acute myocardialinfarction: a core dataset. Royal College of Physicians 1999.2000Birkhead JS. Responding to the requirements of the NationalService Framework for coronary heart disease: a core dataset formyocardial infarction. Heart 2000; 84: 116-72001Birkhead JS, Pearson M, Norris RM et al. Measurement ofClinical Performance: Practical approaches in acute myocardialinfarction. Eds Robert West and Robin Norris. Royal College ofPhysicians 2001.Birkhead JS, Georgiou A, Knight L et al. (eds) A baselinesurvey of facilities for the management of acute myocardialinfarction in England 2000. London: Royal College ofPhysicians 20012002Birkhead JS. The National Audit of Myocardial Infarction: A newdevelopment in the audit process. Journal of Clinical Excellence2002; 4: 379-85.2004Norris RM, Lowe D, Birkhead JS. Can successful treatmentof cardiac arrest be a performance indicator for hospitals?Resuscitation. 2004; 60: 263-269.104 MINAP How the NHS cares for patients with heart attack