Acute Cardiac Care: First-Hour Protocols

What to do in the first hour, when every minute changes the outcome

Acute Cardiac Care: First-Hour Protocols is a seven-hour narrated video course by Dr A M Thirugnanam, Senior Interventional Cardiologist, Researcher, Teacher, Author and Proctor. It teaches emergency physicians, intensivists, cardiology fellows, interventional cardiologists and CCU teams exactly what to do in the first hour of STEMI, NSTE-ACS, cardiogenic shock, VT storm, unstable AF, high-grade AV block, RV infarction, mechanical complications and cardiac arrest.

Built on the textbook Acute Cardiac Care Worldwide: STEMI, Shock, Arrhythmias, and First-Hour Protocols and updated to the 2023 ESC ACS, 2025 ACC/AHA ACS, 2024 ESC AF and 2025 ERC/AHA resuscitation guidance, with the landmark trials behind every decision: COMPLETE, CULPRIT-SHOCK, DanGer Shock, ECLS-SHOCK, STREAM, PLATO, TWILIGHT, AUGUSTUS, TTM2, TOMAHAWK, COACT, ARREST and more.

What is inside

• 28 HD video lectures in eight modules (about seven hours) with flowcharts, dosing tables and trial graphs in every lecture
• The 10-minute ECG-to-decision protocol, STEMI equivalents and occlusion MI
• Primary PCI, fibrinolysis and the pharmaco-invasive strategy, with time targets for every system
• Antiplatelet and anticoagulant choices, bleeding risk and NSTE-ACS timing
• Cardiogenic shock phenotyping, SCAI staging, IABP, Impella, VA-ECMO, vasopressors and inotropes
• VT/VF and electrical storm, unstable AF and SVT, emergency pacing
• RV infarction, VSR, papillary muscle and free wall rupture, LV thrombus and pericarditis
• POCUS and CT in real-time decisions, post-resuscitation care and angiography after arrest
• First-hour bundles, CCU checklists, quality metrics and STEMI networks
• Eight module PDF handouts, 96 module quiz questions and a 64-question final examination
• Academy of Elite Doctors certificate of completion

Curriculum

Module 1: The First-Hour Imperative
Lecture 1: Acute Cardiac Care Worldwide: The First-Hour Imperative
Lecture 2: STEMI Systems of Care: From First Contact to Cath Lab

Module 2: STEMI Recognition and Reperfusion
Lecture 1: The 10-Minute ECG-to-Decision Protocol
Lecture 2: STEMI Equivalents and Occlusion MI
Lecture 3: Primary PCI and the Door-to-Balloon Mandate
Lecture 4: Fibrinolysis and the Pharmaco-Invasive Strategy

Module 3: Antithrombotic Therapy and NSTE-ACS
Lecture 1: Antiplatelet Therapy in ACS
Lecture 2: Anticoagulants and Bleeding in ACS
Lecture 3: NSTEMI and High-Risk UA: Risk Stratification
Lecture 4: Timing the Invasive Strategy in NSTE-ACS

Module 4: Cardiogenic Shock and Circulatory Support
Lecture 1: Cardiogenic Shock: Haemodynamic Phenotyping
Lecture 2: The First Hour in Cardiogenic Shock
Lecture 3: IABP and Impella: Indications and Escalation
Lecture 4: VA-ECMO, Escalation and Weaning
Lecture 5: Vasopressors and Inotropes in Acute Heart Failure

Module 5: Acute Arrhythmias and Emergency Pacing
Lecture 1: Ventricular Arrhythmias: VT, VF and Electrical Storm
Lecture 2: Treating VT Storm: Drugs, Sedation and Ablation
Lecture 3: AF and SVT in the Unstable CCU Patient
Lecture 4: Bradyarrhythmias and Emergency Pacing

Module 6: RV Infarction and Mechanical Complications
Lecture 1: Right Ventricular Infarction and Acute Cor Pulmonale
Lecture 2: Mechanical Complications of Acute MI
Lecture 3: Post-MI Pericarditis, LV Thrombus and Late Complications

Module 7: Imaging and Post-Resuscitation Care
Lecture 1: Point-of-Care Ultrasound in the Acute Cardiac Unit
Lecture 2: Echo and CT Angiography in Real-Time Decisions
Lecture 3: Post-Resuscitation Care: Temperature and Neuroprotection
Lecture 4: Coronary Angiography After Cardiac Arrest

Module 8: First-Hour Bundles and Global Implementation
Lecture 1: First-Hour Bundles and CCU Protocols
Lecture 2: Quality Metrics, Regional Networks and AI

Educational content for healthcare professionals. Verify doses and protocols against current guidelines and your local policy before clinical use.