right coronary artery

Terrifying.

Okay, the map also says leads to an AVF look at the inferior wall implicating the right coronary artery, the RCA.

What's the quirk with that one?

Those leads look up from the bottom, from the diaphragm.

The RCA supplies the bottom of the left ventricle, but crucially, it also supplies the entire right ventricle.

Okay, so why does that matter for treatment?

Because the right ventricle relies heavily on venous blood volume preload to push blood through the lungs, if you see those inferior leads elevated and you give the patient nitroglycerin,

Why would we ever choose to crack a patient's sternum open when we have the elegant stent technology?

There's two main arteries.

There's the RCA and there's the LAD.

Both are key arteries which feed blood to and from your heart.

Basically, when they get blocked, it's like a traffic jam on the M50.

She is P2Y12 inhibitor naive as she was unable to tolerate oral intake due to severe nausea and vomiting.

Coronary angiography reveals a high-grade thrombotic lesion in the mid-right coronary artery.

The interventionalist decides to initiate an intravenous P2Y12 inhibitor before proceeding with PCI.

Which of the following is the most appropriate management strategy? Option A, administer Kangler as a 30 mg per kg IV bolus, followed by a 4 mg per kg per minute infusion for at least 2 hours or the duration of PCI, whichever is longer.

She is P2Y12 inhibitor naive as she was unable to tolerate oral intake due to severe nausea and vomiting.

Coronary angiography reveals a high-grade thrombotic lesion in the mid-right coronary artery.

The interventionalist decides to initiate an intravenous P2Y12 inhibitor before proceeding with PCI.

Which of the following is the most appropriate management strategy? Option A, administer Kangler as a 30 mg per kg IV bolus, followed by a 4 mg per kg per minute infusion for at least 2 hours or the duration of PCI, whichever is longer.

He had stable angina.

He has a severe RCA lesion.

He has more than 70% synosed.

If we pause our angiogram.

Or on IVUS or OCT, having one segment of 270 degrees or more of calcification.

That's a typical... entry criteria for these IVL trials.

So if you just watch that mid right coronary artery, of course, depends on the contrast of my x-ray screen here, but you can see there's actually some heavy calcification just in the mid RCA.

So I have another shot of that here.

[laughs] So-

And the, and, and the problem is you get sent the patient that had 10 beats of non-sustained VT and they want you to do it in a ridiculous RCA or circ, and it's, it's miserable and it's high risk and-

It's all about the mango, baby.

Just put the mango in there.

So-

Like, what are we talking about?

So the RCA, you go, you know, two and a half or three.

Yeah, it goes in the same place all the time.