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Related Concept Videos

Acute Coronary Syndrome I: Introduction01:30

Acute Coronary Syndrome I: Introduction

Acute Coronary Syndrome (ACS) encompasses a spectrum of heart conditions caused by sudden obstruction of coronary arteries, typically resulting from the rupture of an atherosclerotic plaque and subsequent thrombus (blood clot) formation. This obstruction can lead to partial or complete blockage of blood flow, causing varying degrees of myocardial ischemia or infarction.ACS includes the following clinical entities:Unstable Angina (UA)Non-ST-Elevation Myocardial Infarction (NSTEMI)ST-Elevation...
Acute Coronary Syndrome IV: Interprofessional Care01:28

Acute Coronary Syndrome IV: Interprofessional Care

IntroductionThe management of Acute Coronary Syndrome (ACS) aims to minimize myocardial damage, preserve myocardial function, and prevent complications.Initial ManagementInpatient management involves continuous cardiac monitoring, preferably in an ICU, focusing on blood pressure, serum sodium, potassium, and creatinine levels, and urine output. Ongoing pharmacologic management is crucial for stabilizing the patient.Supplemental Oxygen: Administer supplemental oxygen if oxygen saturation is...
Acute Coronary Syndrome V: Nursing Management01:26

Acute Coronary Syndrome V: Nursing Management

Nursing Assessment:Nursing management of acute coronary syndrome (ACS) involves taking the patient's history, focusing on primary complaints such as chest pain, dyspnea, and excessive sweating (diaphoresis), as well as other symptoms like back or jaw pain, nausea, vomiting, palpitations, dizziness, and fatigue. The nurse also reviews the patient's history of cardiac events, risk factors such as hypertension, diabetes, smoking, family history, and current medications.In the objective assessment,...
Ischemic Heart Disease: Overview01:17

Ischemic Heart Disease: Overview

Ischemic heart disease occurs when the heart's blood supply dwindles, causing an ominous lack of oxygen and nutrients. This deficiency, stemming from reduced or obstructed blood flow, spells danger, leading to heart muscle damage and dysfunction.
Atherosclerosis, the primary malefactor, orchestrates this dangerous condition. It manifests as the accumulation of fatty deposits, akin to insidious plaques, within arterial walls. As time elapses, these plaques metamorphose, hardening and narrowing...
Cardiopulmonary Resuscitation IV: Pharmacological Management01:25

Cardiopulmonary Resuscitation IV: Pharmacological Management

Pharmacologic intervention is crucial in treating cardiac arrest patients during ACLS or Advanced Cardiovascular Life Support. The ACLS algorithms guide the administration of specific drugs based on the patient's cardiac arrest rhythm, which includes pulseless ventricular tachycardia (VT), ventricular fibrillation (VF), asystole, and pulseless electrical activity (PEA).EpinephrineIndication: Epinephrine is the first-line drug for all cardiac arrest rhythms.Mechanism of Action: Epinephrine...

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Related Experiment Video

Updated: Jul 14, 2026

Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
09:21

Optimized Management of Endovascular Treatment for Acute Ischemic Stroke

Published on: January 18, 2018

Revascularization algorithm in acute STEMI should take into account age.

Axel de Labriolle1, Bruno Giraudeau, Gérard Pacouret

  • 1Département de Cardiologie, Centre Hospitalier Universitaire Tours, Tours, France. a.delabriolle@chu-tours.fr

Cardiovascular Revascularization Medicine : Including Molecular Interventions
|June 19, 2007
PubMed
Summary

For elderly STEMI patients, time to treatment impacts outcomes differently based on reperfusion strategy. Primary PCI showed a correlation between longer treatment times and mortality, unlike thrombolysis.

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Area of Science:

  • Cardiology
  • Geriatric Medicine
  • Interventional Cardiology

Background:

  • Optimal reperfusion strategy for elderly ST-segment elevation myocardial infarction (STEMI) patients remains debated.
  • Limited data exists on the impact of time to treatment (TT) on STEMI prognosis in this demographic.

Purpose of the Study:

  • To analyze the real-world association between time to treatment (TT) and 1-year mortality in elderly STEMI patients (> or =75 years).
  • To compare outcomes for patients treated with thrombolysis (THL) versus primary percutaneous coronary intervention (PCI).

Main Methods:

  • Prospective registry data from 1995-2005 was analyzed for 159 elderly STEMI patients (<12h symptom onset).
  • Patients underwent either THL (n=35) or primary PCI (n=124).
  • Logistic regression assessed the relationship between TT and 1-year mortality for each reperfusion strategy.

Main Results:

  • Time to treatment was not significantly associated with mortality after thrombolysis (P=.81).
  • Time to treatment was positively correlated with mortality after primary PCI (P=.03).
  • One-year all-cause mortality was significantly higher in the THL group (51.4%) compared to the PCI group (15.3%; P<.001).

Conclusions:

  • Reperfusion strategies used for younger STEMI patients may not be suitable for the elderly.
  • Specific treatment algorithms and recommendations are necessary for optimizing STEMI care in elderly populations.