The intent of this presentation is to provide an update of coronary assessment and management for the adult intensivist. Discussion points will include:

1. An assessment of coronary severity, using established methods, in particular fractional flow reserve (FFR),

2. Which stent- highlight the evolution of the stent to the current generation and what is evolving,

3. How to keep the stent open with current concepts of antiplatelet therapy and how this impacts the critically ill patient

4. What to consider if the ECG is abnormal, but the coronaries are not flow limiting obstruction- an occasional dilemma in the critically ill patient and finally

5. Discussion around a contemporary study regarding cardiogenic shock and coronary ischemia.