Ricerca Medico

Interventional Cardiology Hemodynamics

Interventional Cardiology Hemodynamics
Head of the medical team: Dr. Ciro De Simone (Clinical Commissioning Group North Naples)

Located on the 1st floor of building B, the Interventional Cardiology Hemodynamics Unit has twenty beds with rooms of three beds. All rooms have a private bathroom, air conditioning, television and a cupboard for patients’ clothes.
The medical team consists of three interventional cardiologists and four nurses, present every day of the week from 8.00 am to 8.00 pm. The team is also always available at night and during holidays to ensure the service of primary angioplasty H24.
Who it is for

In Italy ischemic heart disease affects 5% of the population with 2,000,000 patients and 350,000 new cases each year.
Acute myocardial infarction with ST­segment elevation is the most serious manifestation of heart disease. In patients affected by the disease one of the three main branches that carry blood to the myocardium becomes blocked completely because an atherosclerotic plaque ulcers and causes the formation of a thrombus into the blood vessel. The myocardial tissue that is downstream of the occluded artery does not receive any more blood (nor, therefore, oxygen and nutrients), so the patient can die within a few hours. Complications of the disease are many and range from heart failure to death.

How to intervene

Nowadays the best treatment is to reopen the blood vessel as quickly as possible and restore blood flow to the area that was going to necrotize.

The reopening of the blood vessel or reperfusion therapy can be done in two ways:

  • Drug: systemic thrombolysis
  • Mechanics: primary angioplasty

Thrombolysis unfortunately is only effective in 50­60% of cases and is associated with a significant number of potentially serious bleeding complications which may be lethal.

Primary angioplasty instead is effective in 98% of cases and allows a full reopening of the vessel. Being a procedure performed in high­risk patients and in emergency it is not without complications but clinical studies of thousands of patients have clearly demonstrated its efficacy, safety and superiority over thrombolysis. Today it is considered the best treatment by the latest European and American guidelines.

When to intervene

The indications and timing for primary angioplasty are the following:

  • When you can do so within 90 minutes of first medical contact
  • Cardiogenic shock within 18 hours of the onset of the same.
  • STEMI at high risk of mortality (congestive heart failure, pulmonary edema, electrical instability).
  • Inferior myocardial infarction with left ventricular involvement.
  • Late presentation (onset of symptoms for more than three hours).
  • When there aren’t signs of reperfusion after 90 minutes from the start of thrombolytic therapy: persistent angina, of ST elevation, hemodynamic deterioration, electrical instability (PTCA rescue).
  • Contraindication to thrombolytic therapy.
Dr. Ciro De Simone
Head of the medical team
Giovanni De Rosa
Head of hospital nursery
Si avvisano i Sigg. Utenti che le prenotazioni telefoniche presso il CUP possono essere effettuate dalle 13.3O alle 16.OO dal lunedì al venerdì. Grazie per la collaborazione