Sorry, for that mis-communication,.. we are just macro-vascular cardiologists!
January 28, 2026 by dr s venkatesan
This is not an completely Imaginary conversation, between the wife of a recently discharged STEMI patient and his cardiologist, in a top ranked heart care center in my city Chennai.
Caution: Strong language
Patient’ s wife :
Doctor, why my husband is suffering from significant LV dysfunction inspite of a timely & successful primary PCI. You assured me you are doing the best.
Cardiologist:
Yes, you are right. Iam sorry, for that.
Patient’s wife :
But, doctor, on the day of discharge you told us proudly, the procedure is 100% success and you have relieved the block and restored blood flow. You quoted some Tomy score, and all.
Cardiologist:
Yes I did. It is not Tomy, it is TIMI 3, which we use routinely, and … to be frank, it actually means nothing. It tells us, we restored flow across the artery at the site of block . It can never gauarantee, all those blood, will reach the ailing muscle.
Patient’ wife
TIMI or TAMY, doesn’t mean anything to me doctor. It sounds like my neighbour’s pet. All I want to understand is , whether the procedure was really successful. Yes or No ?
Cardiologist
Yes , you are correct. I am extremely sorry. It is really an Incomplete myocardial salvage.Your husband’s myocardium is significantly damaged. You must also understand , it is not in our hands.It is destiny, that lies deep in the myocardial microvasculature, which doesn’t obey our conventional time windows.
Patient’s wife
Thats ok. But, what is the need for miscommunication to us. It was Indeed a case of failed primary PCI.
Cardiologist
Probaly yes.But, scientifically it is not a falsehood. For us, it is still a success, because we are just macro-vascular cardiologist.We define sucesss based on removing blocks, not the true myocardial reperfusion.
Patients wife
Thats awful. Sorry, for being harsh .Please go and change the definition in your literature doc.
Cardiologist
Thanks for bringing up this less discussed entity “Failed primary PCI” We rarely mind about it (For us, only thrombolysis can fail) . Surely, we will pass on your concern to the concerned authorities.
