Urgent coronary angiography after cardiac arrest

Which patients after cardiac arrest should undergo urgent coronary angiography? Should they be transported to an intensive care unit (ICU) first or directly to a catheterization laboratory?

Zaza Iakobishvili, MD, PhD: I think that the patient with STEMI, ST-segment elevation myocardial infarction, out-of-hospital resuscitated cardiac arrest should go to primary percutaneous coronary intervention (PCI) immediately. The first place in the hospital must be the cath lab. After the cath lab, they are going to postresuscitation care—hypothermia and all the other things we need for life support.

On the other hand, when you do not know the exact diagnosis of out-of-hospital cardiac arrest victims and you think that it may be acute myocardial infarction, in this case you have to weigh all pros and cons of this situation. Only in this case, when you are sure that you are dealing with a patient with acute coronary syndrome (ACS), coronary angiography must be performed.