Auricle (right atrium)
Inferior vena cava
Left mainstem coronary artery
Left anterior descending coronary artery
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1. Is the size of the heart normal?
2. Is the amount of epicardial fat normal?
3. An area of scarring is identified. Where is it located on the heart? This same area is identified in Part 4. The surrounding hemorrhage is more difficult to see now than it was in Part 4. Go back to Part 4 and try to identify the area. What is the significance of hemorrhage around a scar on the heart? Is this the cause of death? Is this an incidental finding? Does this area reflect an acute process? A chronic process? Both? Why? What coronary artery supplies this area?
4. Pause the video in anterior view. Draw out the coronary systemuscle
5. Pause the video in posterior view. Draw out the coronary systemuscle
6. Identify the main external anatomy (left ventricle, right ventricle, etc.).
7. Does the video show a possible cause of death?
8. What would be the clinical significance of severe blockage in the left mainstem vs. the left anterior descending coronary artery?
9. How much blockage is considered “clinically significant”?
10. What causes coronary artery disease?
11. How long do you think this patient lived with this amount of blockage?
12. What are the indications for coronary artery bypass vs. coronary stent vs. balloon angioplasty?
13. Which treatment option would you select in a patient with this level disease? Or what else would you need to know to make a determination?
14. You are called to the scene of collapse as an emergency service provider; and informed by the patient’s partner that he had a severe blockage of the left anterior descending coronary artery? What specific resuscitation measures would you take for a patient with that history?
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